- A Study on Resistance in Type 2 Diabetic Patient Against Commencement of Insulin Treatment.
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Sun Hwa Hong, Mi Jin Kim, Sung Gab Noh, Dae Won Suh, Suk Jung Youn, Kwan Woo Lee, Ho Chae Lee, Yang Soo Chung, Hong Ryang Chung, Hyuk Sang Kwon, Bong Yun Cha, Ho Young Son, Kun Ho Yoon
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Korean Diabetes J. 2008;32(3):269-279. Published online June 1, 2008
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DOI: https://doi.org/10.4093/kdj.2008.32.3.269
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- BACKGROUND
To achieve tight glycemic control in the poorly controlled type 2 diabetic patients with oral hypoglycemic agent, it maybe beneficial to initiate insulin treatment at the early stage. Many patients with type 2 diabetes are often reluctant to begin insulin therapy despite poor glycemic control with oral hypoglycemic agents, this little known phenomenon, often termed 'psychological insulin resistance (PIR)'. This study investigates psychological insulin resistance in Korean patients with type 2 diabetes. METHOD: This study examined a total of 76 type 2 diabetic patients with poor glycemic control during period of April to July 2006. Through questionnaire and telephone survey, total 24 questions were asked about various attitudes on insulin therapy including psychological barriers and patients' acceptance of this treatment. Subjects were asked to allocate points in 5-point scale (from 5 points for 'very true' to 1 point for 'very untrue'). RESULTS: The means of psychological rejection, injection-related anxiety and fear of insulin side effects such as hypoglycemia and weight gain were 3.65 +/- 0.92, 3.17 +/- 0.98 and 2.8 +/- 1.02, respectively. Unwillingness was common in insulin therapy, 67% of patient rejected or was unwilling to take insulin. Main reasons of patients most frequently endorsed beginning insulin indicate that disease is worsening, permanence (once you start insulin you can never quit) and sense of personal failure. Furthermore, study indicates that patients' reasons for avoiding insulin therapy were mainly psychological rejection, which extended far beyond a simple injection related anxiety. CONCLUSION: PIR was psychological reluctance rather than injection related anxiety. To overcome these psychological barriers to insulin treatment, it is necessary to address appropriate diabetes education including training and counseling with excellent interactive communications between patients and clinicians.
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Citations
Citations to this article as recorded by  - Using Motivational Interviewing to Overcome Psychological Insulin Resistance
Sung-Chul Lim
The Journal of Korean Diabetes.2023; 24(4): 227. CrossRef - Psychological Insulin Resistance: Key Factors and Intervention
Yeon Jeong Jang
The Journal of Korean Diabetes.2021; 22(3): 192. CrossRef - Factors influencing psychological insulin resistance in type 2 diabetes patients
Ji Hyeon Yu, Hye Young Kim, Sung Reul Kim, Eun Ko, Heung Yong Jin
International Journal of Nursing Practice.2019;[Epub] CrossRef - Development of a Psychological Insulin Resistance Scale for Korean Patients with Diabetes
Youngshin Song, Younghee Jeon, Jeonghwa Cho, Bohyun Kim
Journal of Korean Academy of Nursing.2016; 46(6): 813. CrossRef - Patients' perspectives on taking insulin in diabetes - Perspectives of convergence
Youngshin Song, Eunkyong Ah
Journal of Digital Convergence.2016; 14(12): 283. CrossRef - Concept Analysis for Psychological Insulin Resistance in Korean People with Diabetes
Youngshin Song
Journal of Korean Academy of Nursing.2016; 46(3): 443. CrossRef - New Insulin Injection Recommendations
Min Jeong Gu
The Journal of Korean Diabetes.2016; 17(4): 261. CrossRef - Glucose, Blood Pressure, and Lipid Control in Korean Adults with Diagnosed Diabetes
Sun-Joo Boo
Korean Journal of Adult Nursing.2012; 24(4): 406. CrossRef
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