Abstract
Problems may arise with insulin treatment, due to patients' perspective towards it leading to refusal. To evaluate diabetic patients' refusal towards insulin therapy, and to assess patients' perception and perceived barriers towards insulin. A cross-sectionalstudy, where type 2 diabetics participated in the study during a period, February through March 2017. They were interviewed in person by a questionnaire including three sections; socio-demography, medical history and a health belief model, comprising barriers to use insulin. Five points Likert scale was used to measure patients' perception and barriers towards insulin therapy. One fourth (24.4%) of the diabetic patients refused insulin. Among the controlled group, 34.4% refused insulin, while 21% refused insulin among the uncontrolled group. The study showed different barriers towards insulin therapy, including fear of injection, pain, insulin injection needs help from others, fear of hypoglycaemia and embarrassment. Diabetics showed a negative attitude towards insulin therapy due to social and psychological factors. The results necessitate the development of a strategy to address problems related with a reluctance to initiate insulin and put a strategy to implement education and better interaction with diabetic team to the stigma from phobia from insulin use.
Highlights
All over the world, an estimated 382 million people are living with diabetes, and this number is expected to rise to 592 million by 20351
The study conducted in London by Khan et al among Bangladeshi patients with poorly controlled type 2 diabetes showed that 20.3% refused to commence insulin therapy despite repeated counseling[7] and in another study conducted by Karter et al in the United States (US) revealed that 35% refused insulin for many reasons[8]
Guidelines for management of diabetes recommend the use of oral hypoglycemic drugs (OHDs) as monotherapy or as combination therapy with or without insulin
Summary
An estimated 382 million people are living with diabetes, and this number is expected to rise to 592 million by 20351. There are many causes for refusal of insulin therapy by African Health Sciences diabetics as well as several patient related factors for delay in insulin initiation. These factors have been studied by many researchers in Saudi Arabia in 20145 as well as other countries such as Korea[6], England and United States (US)[6,7,8]. Methods: A cross-sectionalstudy, where type 2 diabetics participated in the study during a period, February through March 2017 They were interviewed in person by a questionnaire including three sections; socio-demography, medical history and a health belief model, comprising barriers to use insulin.
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