Abstract
BackgroundInsulin therapy is necessary for patients with type 2 diabetes mellitus (T2DM) to reach the targeted glycaemic level and prevent complications. This study aimed to determine the proportion of adherence to insulin therapy and the associated factors in patients with T2DM.MethodsA cross-sectional study was conducted among 249 patients with T2DM who had been on insulin therapy for at least 2 months in primary care centres of the Ministry of Health in Klang, Malaysia. A validated insulin adherence questionnaire for diabetes mellitus (DM) was used to assess insulin adherence. Data on the sociodemographic characteristics, disease-related factors, treatment-related factors and clinical parameters were extracted from medical records and interviews with patients.ResultsThe adherence to insulin therapy was 8.43%. The factors associated with insulin adherence were self-monitoring of blood glucose (SMBG) (adjusted odds ratio [AOR]: 5.39; 95% confidence interval (CI): 1.20, 24.13; P = 0.028), exercise (AOR: 3.38; 95% CI: 1.37, 10.03; P = 0.029) and the number of daily insulin injections (AOR: 1.63; 95% CI: 1.09, 2.44; P = 0.017).ConclusionThe adherence to insulin therapy in primary health care centres in Malaysia was very poor. Patients who practiced SMBG, exercised and frequent daily insulin injections were significantly more adherent to insulin therapy.
Highlights
Type 2 diabetes mellitus (T2DM) is a common chronic disease worldwide and its trends are increasing year after year [1].Diabetes mellitus (DM) caused 1.5 million deaths worldwide in 2012 and contributed to an additional 2.2 million deaths due to the increased risks of cardiovascular disease and other complications [2]
Our study found that a patient practicing self-monitoring of blood glucose (SMBG) had 5.39 times more likely to adhere to insulin therapy compared to a patient who was not practicing SMBG
Our study found that the duration of DM had no association with adherence to insulin therapy while other studies concluded that the longer duration of DM leads to poorer adherence to insulin therapy [14, 29]
Summary
Type 2 diabetes mellitus (T2DM) is a common chronic disease worldwide and its trends are increasing year after year [1]. Diabetes mellitus (DM) caused 1.5 million deaths worldwide in 2012 and contributed to an additional 2.2 million deaths due to the increased risks of cardiovascular disease and other complications [2]. In 2015, 17.6% of people aged 40 years old–44 years old had DM, compared to 10.3% in. Those aged 45 years old–49 years old experienced an increase of 15%–20.6% in the same year [4]. Insulin therapy is necessary for patients with type 2 diabetes mellitus (T2DM) to reach the targeted glycaemic level and prevent complications. This study aimed to determine the proportion of adherence to insulin therapy and the associated factors in patients with T2DM
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