Self-Management of Type 2 Diabetes (T2DM) by Maltese Migrants in Australia: Can Community Pharmacies Play a Supporting Role?

Abstract

Objectives: The objective of this research was to explore patients’ lived-experience of insulin therapy and to increase effective diabetes management. This study targeted type 2 diabetes patients in a public hospital in the Federal territory ofMalaysia; exploring their experiences of using insulin as part of their glycemic control, and developing theory with regards to their perceptions of health, wellbeing and quality of life while identifying barriers and facilitators to initiating insulin therapy. The objective is to increase the focus on the patient, especially the psychological, social and behavioural barriers to effective diabetes management. Methods: This qualitative research utilised interpretivist paradigm and phenomenological approach. Purposive sampling method was used to select type 2 diabetes patients who are on insulin therapy at a public hospital in Malaysia. Unstructured interviews are used for data collection, the interviews were transcribed verbatim and analysis adopted the principles of grounded theory and narrative approaches. Results: Patients who have been using insulin for glycemic control more than one year are positive towards the treatment. Initial codings from four interviews revealed that supportive information is very crucial before patients are initiated with insulin treatment. In one case, patient felt that he has been ‘left in a dark room’. Although Insulin injection technique was shown to him, he was not given much information and counselling on insulin and the disease itself. He mentioned that during that time, internet was not readily available and health information was not easily accessible. Another female patient explained that she did have the stigma that insulin signified ‘teruk’ (bad/failure). However she was able to understand after counselling. Conclusions: Malaysian patients with type 2 diabetes still have some myths and stigma about insulin therapy, but they feel in ‘full control’ of the medication use given initial doubts and limited information. Further studies are required for patients’ specific perceptions about the insulin management.