Frequency of Insulin Omission and It’s Associated Factors in Patients with Type 2 Diabetes Mellitus on Insulin Therapy

Abstract

ABSTRACT Background: Poor adherence to prescribed insulin regimen leads to poor glycemic control. This study was intended to see the frequency of insulin omission and it's associated factors among patients with inadequate glycemic control on insulin therapy. Methods: This cross-sectional observational study enrolled 384 patients with type 2 diabetes on insulin therapy recruited by convenient sampling from the Department of Endocrinology of BIRDEM General Hospital. As per study protocol, investigation reports were collected from patient records. Data were analyzed by SPSS version 25. Results: Forty-six percent of patients had some form of insulin omission. A documented event of one or more episodes of hypoglycemia (70.7%) was found to be the prime reason behind the omission of insulin. Worsened glycemic control (fasting plasma glucose, 2-h postprandial glucose, and glycated hemoglobin) and health hazard (obesity) were statistically significantly higher among the subjects who omitted their insulin. Only a few people in the insulin omission group were compliant with diet (2.8%), exercise (5.1%), and weekly self-monitoring of blood glucose (2.8%). Only 22.5% and 21.3% knew about target blood glucose and the insulin dose adjustment, respectively, in the omission group. Conclusions: High frequency of insulin omission due to several lifestyle-related factors and lack of structured diabetic education predisposed the patients to poor glycemic control.