Beliefs of Caribbean type 2 diabetes patients towards insulin therapy and prescription
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ORIGINAL ARTICLE
Beliefs of Caribbean type 2 diabetes patients towards insulin therapy and prescription Chidum E. Ezenwaka 1
&
Philip Onuoha 1 & Rian Extavour 1 & Safiya Yearwood 1
Received: 5 December 2018 / Accepted: 30 January 2020 # Research Society for Study of Diabetes in India 2020
Abstract Background and aim Previous research studies have shown that poorly controlled type 2 diabetes patients do not receive insulin therapy because of the resistance of the patients to insulin therapy. This study aimed to assess the belief of Caribbean insulinnaïve type 2 diabetes patients on insulin therapy. Methods Five hundred ten insulin-naïve type 2 diabetes patients who have had diabetes for at least 5 years were recruited for a questionnaire interview. The questionnaire was a modified version of a previously validated research questionnaire. Data collected was analysed with SPSS software using chi-square to test for significances. Results The majority of the patients have had diabetes for > 10 years and take > 2 different diabetes medications daily. About 67% and 81% of the patients do not believe that insulin therapy will cause them hypoglycemia and weight gain respectively. Similarly, a significant percentage does not believe that taking insulin will interfere with their normal lifestyle activities (72.2%, p = 0.048). Although a majority (64%) of the patients believe that taking insulin translates to personal failure in optimal blood glucose control, 90% do not believe that taking insulin will cause people to treat them differently. A majority of the patients do not believe that taking insulin will be helpful in preventing long-term diabetes complications (63.9%, p = 0.001), though 51% thought it would make them feel better. Conclusion Contrary to several reports, this study shows that insulin-naïve Caribbean type 2 diabetes patients do not have a significant negative perception towards insulin therapy. This finding might be related to the socio-cultural background of the patients studied. Keywords Type 2 diabetes . Glycemic control . Insulin therapy . Insulin prescription . Beliefs . Developing country
Introduction Type 2 diabetes is the commoner type of diabetes in Trinidad and Tobago and worldwide, and research evidence from our laboratory and elsewhere has shown major challenges in optimally controlling the blood glucose levels of the affected patients [1–5]. This is essentially due to both defective insulin secretion and insulin action [6]. The United Kingdom Prospective Diabetes Study (UKPDS) has shown that at diagnosis most type 2 diabetes patients had only 50% of normal insulin secretion which decreases to 25% after 6 years of * Chidum E. Ezenwaka [email protected]; [email protected] 1
Department of Para-Clinical Sciences, The Diabetes and Metabolism Research Group [DMRG], Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago
diabetes duration [6]. We have previously shown that poor glycemic control of type 2 diabetes patient
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