scholarly journals Attitude and Compliance with the Onset of Insulin Therapy in Patients with Type 2 Diabetes

2020 ◽  
Vol 21 (6) ◽  
Author(s):  
Zahra Davoudi ◽  
Arezoo Chouhdari ◽  
Mahshid Mir ◽  
Fatemeh Akbarian
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Health Care Providers ◽  
Insulin Injection ◽  
Diabetic Patients ◽  
Care Providers ◽  
Type 2 Diabetic Patients ◽  
Negative Attitudes ◽  
Type 2 Diabetic

Background: Insulin therapy refusal among type 2 diabetic patients is most challenging for healthcare providers. Objectives: This study aimed to evaluate the type 2 diabetic patients’ attitude and compliance with the initiation of insulin therapy. Methods: A cross-sectional study was conducted on 100 type 2 diabetic patients at the Endocrinology Clinic of Loghman Hakim Hospital, Tehran, Iran. A questionnaire was prepared to assess the attitudes toward the onset of insulin therapy. Positive and negative attitudes toward insulin injection were compared between the two groups of accepting and rejecting insulin therapy. Results: In this study, 62% of patients with type 2 diabetes tended to start insulin therapy. There was a statistical difference between the total positive and negative attitude items toward insulin therapy (agree/disagree) and acceptance of insulin therapy (P < 0.05). The most agreements related to a positive attitude in the two groups of accepting and rejecting insulin therapy belonged to statements “Insulin injection prevents complications of diabetes (micro and macrovascular)” as 100% (P < 0.001) and “Insulin injection helps improve my diabetes” as 96.8% (P < 0.001). The most agreements related to negative attitudes in the two groups of accepting and rejecting insulin therapy belonged to statements “Insulin injection causes my dependence on it” as 72.6% (P = 0.001) and “I can control my diabetes with oral medication and diet without insulin injection” as 97.4% (P < 0.001). Conclusions: As 38% of patients with type 2 diabetes refused to initiate insulin therapy, it seems that effective communication between physicians and patients and continuous follow-ups by health care providers can increase positive attitudes toward insulin injection.

scholarly journals Dinamika massy tela u bol'nykh sakharnymdiabetom 2 tipa v techenie pervogo godainsulinoterapii

2010 ◽  
Vol 7 (4) ◽  
pp. 13-19 ◽  
Author(s):  
T Sh Dzhavakhishvili ◽  
T I Romantsova ◽  
O V Roik
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Insulin Therapy ◽  
Insulin Requirement ◽  
Insulin Analogues ◽  
First Year ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

The aim of this study was to determine changes in weight and insulin requirements in insulin-treated type 2 diabetic patients with normal and elevated body mass index (BMI) during the first year after initiating the insulin therapy with insulin analogues or human insulins, respectively. Materials and methods: a total of 157 patients with insulin naive type 2 diabetes were included in the study. The patients were divided in two groups. First group consisted of subjects [mean age 57 (45 to 73), duration of diabetes of 10 years (4 to 16)] prescribed a long-acting basal (glargine, detemir), premixed (biphasic insulin Aspart 30, Humalog Mix 25) or short-acting (aspart, lispro) insulin analogues. Patients from second group [mean age 59 (46 to 75), duration of diabetes for 10 years (5 to 15)] were treated with intermediate- acting basal (Protophane, Humulin NPH), premixed (biphasic human insulin 30, Humulin M3) and regular (Actrapid, Humulin R) human insulins. Each of these two groups was divided into three subgroups depending on the baseline body mass index (BMI) of the patients: 18,5-24,9; 25-29 and ≥30. At the beginning of insulin therapy and 12 months later, we compared HbA1c, BMI, waist circumference and required insulin doses in each group. Results: our study results showed that under comparable metabolic control the risk for weight gain and increase in insulin requirement is similar in insulin-treated type 2 diabetic patients with normal and elevated BMI. Use of insulin analogues for treatment of type 2 diabetes patients with normal and elevated BMI results in better glycaemic control, less weight gain, smaller increase in insulin requirement and waist circumference compared to human insulins during the first year of insulin therapy.

scholarly journals Prevalence and determinants of psychological insulin resistance among type 2 diabetic patients in Kinshasa, Democratic Republic of Congo

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Shomba L. Rita ◽  
Fina J.-P. Lubaki ◽  
Lepira F. Bompeka ◽  
Gboyega A. Ogunbanjo ◽  
Lukanu P. Ngwala
Keyword(s):  
Insulin Resistance ◽  
Health Care Providers ◽  
Negative Impact ◽  
Therapeutic Education ◽  
Diabetic Patients ◽  
Care Providers ◽  
Type 2 Diabetic Patients ◽  
Female Ratio ◽  
Type 2 Diabetic

Background: Psychological insulin resistance (PIR) is a common but unappreciated phenomenon by health care providers with a negative impact on the control of type 2 diabetes mellitus.Aim: To determine the frequency of PIR and its determinants in patients with type 2 diabetes.Setting: This study was conducted in Kinshasa in three health centres providing management of diabetic patients.Methods: This study was a multicentric, cross-sectional study conducted from 01 November 2017 to 31 March 2018 in Kinshasa among 213 type 2 diabetic patients who were taking oral anti-diabetic drugs. A standardised questionnaire, the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ), was used for data collection.Results: The average age of participants was 59.8 ± 11.1 years with a male to female ratio of 1.5. The prevalence of PIR was 42.7%; and its main determinants were 50 years of age (odds ratios [OR] adjusted 2.05; 95% confidence interval [CI] 1.98–4.27; p = 0.045), the presence of complications (OR adjusted 3.33; 95% CI 1.68–6.60; p = 0.001), lack of knowledge about insulin therapy (OR adjusted 1.96; 95% CI 1.03–3.71; p = 0.040) and the high cost of insulin (OR adjusted 2.32; 95% CI 1.08–4.95; p = 0.030).Conclusion: The study showed that almost half of type 2 diabetic patients had PIR with the main determinant factors related to the patient and the health system. The establishment of a therapeutic education programme, improved ‘provider–patient’ communication and the development of approaches to increase access to drugs are crucial to reduce the prevalence of PIR.

scholarly journals Influence of the dynamics of body weight on the risk factors of cardiovascular disease in patients with type 2 diabetes during the first year of insulin treatment

2013 ◽  
Vol 10 (1) ◽  
pp. 22-25
Author(s):  
T S Dzhavakhishvili ◽  
T I Romantsova ◽  
O V Roik
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Insulin Treatment ◽  
Insulin Analogues ◽  
First Year ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

The aim of the present study was to investigate whether insulin treatment-induced weight gain had an adverse impact on cardiovascular risk factors in insulin-treated type 2 diabetic patients during the first year after initiating insulin therapy when insulin analogues or human insulins are used. A total of 157 patients with newly insulinized type 2 diabetes were included in the study. The patients were divided in two groups. First group consisted of subjects (mean age 57 [45; 73], duration of diabetes of 10 years [4; 16]) who had received long-acting basal (glargine, detemir), premixed (biphasic insulin aspart 30, Humalog Mix 25) or short-acting (aspart, lispro) insulin analogues. Patients from second group (mean age 59 [46; 75], duration of diabetes of 10 years [5; 15]) were treated with intermediate-acting basal (Protophane, Humulin NPH insulin), premixed (biphasic human insulin 30, Humulin M3) and regular (Actrapid, Humulin R) human insulins. Our study has shown that insulin-induced weight gain may not adversely affect cardiovascular risk factors, particularly, lipid profile, in insulin-treated type 2 diabetic patients during the first year after initiating insulin therapy. Use of insulin analogues for treatment of type 2 diabetes patients results in better glycaemic control, significant declines in blood lipid concentrations, less increase in waist circumference compared with human insulins during the first year after initiating insulin therapy.

The Relationships among the Organizational Factors of a Tertiary Healthcare Center for Type 2 Diabetic Patients in Palestine

2020 ◽  
Vol 20 ◽  
Author(s):  
Rami Mosleh ◽  
Mohammed Hawash ◽  
Yazun Jarrar
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Health Care Providers ◽  
Organizational Factors ◽  
Patient Characteristics ◽  
Diabetic Patients ◽  
Care Providers ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional

Background: Diabetes prevalence at Palestine was 10%, with a rising fund crisis, and diabetes healthcare problems. There was a limited research concerning diabetes healthcare dimensions including organizational factors and their predictors. Objectives: This study described patient characteristics and organizational factors, and assessed relationships among organizational factors of type 2 diabetes health care in Palestine. Methods: This study is retrospective cross sectional, recruited by convenience sampling method in 330 participants from a type 2 diabetes patients list. It was carried out at Ramallah, Palestine. The Statistical Package for Social Sciences (SPSS v 19) was used to analyze data on patient characteristics and organizational factors collected from personal interview and medical records review. Results: The results showed that 51.2% were males, and 88.5% had additional chronic diseases. Preventive healthcare and patient–healthcare professionals’ relationship were the most prominent organizational factors in statistically significant relationships among organizational factors. Conclusion: This study reflected the need for reviewing prescription mode, and educational programs that emphasize the diabetes self–care management and the health care providers’ role that would be of great benefit in health outcomes further.

scholarly journals Az inzulinkezelés elkezdésének gyakorlati akadályai 2-es típusú cukorbetegekben – a „pszichológiai inzulinrezisztencia” leküzdése

2019 ◽  
Vol 160 (3) ◽  
pp. 93-97
Author(s):  
Olivér Rácz ◽  
Marcela Linková ◽  
Krzysztof Jakubowski ◽  
Robert Link ◽  
Daniela Kuzmová
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Providers ◽  
Insulin Treatment ◽  
Clinical Inertia ◽  
Diabetic Patients ◽  
Care Providers ◽  
Type 2 Diabetic Patients ◽  
Mutual Cooperation ◽  
Endogenous Insulin

Abstract: Type 2 diabetes is a progressive disease and its consequence is the gradual decrease of endogenous insulin secretion to a very low level. Beyond this point, without insulin it is not possible to achieve proper metabolic compensation. The authors are trying to explain why the insulin therapy is often delayed in type 2 diabetic patients despite existing guidelines about its initiation and continuation. The causes of delay can be divided into two groups. One is the fear and disagreement of the patients (psychological insulin resistance – PIR) arising from different cognitive, emotional and other reasons. The second is the “clinical inertia”, when the physicians are not able to explain in an effective and persuasive way the rationale and necessity of insulin treatment to their patients. The common background of both causes is the lack of sufficient knowledge about the pathogenesis of type 2 diabetes and the rationale of insulin treatment together with an insufficient level of communication between doctor and patient. The authors see the solution in the improvement of pre- and postgradual education of doctors and other health care providers (nurses, educators, psychologists), in their mutual cooperation and the translation of their knowledge towards a system of successful patient education. Orv Hetil. 2019; 160(3): 93–97.

scholarly journals Circulating C1q/TNF-Related Protein 3, Omentin-1 and NGAL in Obese Patients with Type 2 Diabetes During Insulin Therapy

2019 ◽  
Vol 8 (6) ◽  
pp. 805 ◽  
Author(s):  
Katarzyna Komosinska-Vassev ◽  
Pawel Olczyk ◽  
Kornelia Kuźnik-Trocha ◽  
Agnieszka Jura-Półtorak ◽  
Alicja Derkacz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Plasma Concentration ◽  
Insulin Therapy ◽  
Diabetic Patients ◽  
Obese Patients ◽  
Related Protein ◽  
Type 2 Diabetic Patients ◽  
Plasma Profile ◽  
Type 2 Diabetic

The aim of the study was to quantify the plasma concentration of omentin-1, neutrophil gelatinase-associated lipocalin (NGAL), and complement C1q tumor necrosis factor-related protein-3 (CTRP3) in obese patients with type 2 diabetes, before introducing insulin therapy, in relation to the plasma expression profiles of these regulatory molecules in the same patients after a 6-month insulin mixture therapy and in obese controls. Elevated plasma NGAL concentrations were found in type 2 diabetic patients as compared with subjects with metabolically healthy obesity. In turn, a 6-month insulin mixture therapy has shown a marked increase in the plasma concentration of omentine-1 and a significant decrease in plasma CTRP3 concentration in obese patients with type 2 diabetes, in relation to the values found in these patients before the implementation of insulin therapy. Insulin mixture therapy has also proved to be an important factor modifying the plasma profile of NGAL, increasing the concentration of this bioactive molecule in the plasma of patients with type 2 diabetes, after 6 months of its use, in relation to the concentration before treatment. The significant changes in the plasma profile of omentin-1, NGAL and CTRP3 during insulin therapy suggest their potential diagnostic utility in monitoring metabolic changes associated with the introduction of insulin treatment in type 2 diabetic patients.

scholarly journals Impact of a Booklet about Diabetes Genetic Susceptibility and Its Prevention on Attitudes towards Prevention and Perceived Behavioral Change in Patients with Type 2 Diabetes and Their Offspring

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Masakazu Nishigaki ◽  
Eiko Sato ◽  
Ryota Ochiai ◽  
Taiga Shibayama ◽  
Keiko Kazuma
Keyword(s):  
Type 2 Diabetes ◽  
Genetic Susceptibility ◽  
Behavioral Change ◽  
Behavioral Changes ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
The Patient’S View ◽  
Self Administered Questionnaire ◽  
Type 2 Diabetic

Background. Offspring of type 2 diabetic patients are at a high risk of type 2 diabetes. Information on diabetes genetic susceptibility and prevention should be supplied to the offspring.Methods. A six-page booklet on diabetes genetic susceptibility and prevention was distributed to 173 patients who ere ordered to hand it to their offspring. The patients answered a self-administered questionnaire on booklet delivery and attitudinal and behavioral changes toward diabetes and its prevention in themselves and their offspring.Results. Valid responses were obtained from 130 patients. Forty-nine patients had actually handed the booklet. Booklet induces more relief than anxiety. From the patient's view, favorable attitudinal and/or behavioral changes occurred in more than half of the offspring who were delivered the booklet.Conclusion. The booklet worked effectively on attitudes and behaviors toward diabetes and its prevention both in patients and their offspring. However, the effectiveness of patients as information deliverers was limited.

Awareness of Complications in Diabetic Patients - Study in a Tertiary Care Centre in Kerala

2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Type 2 Diabetic Patients ◽  
Complications Of Diabetes ◽  
Type 2 Diabetic

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes

scholarly journals Increased Urine IgM and IgG2Levels, Indicating Decreased Glomerular Size Selectivity, Are Not Affected by Dalteparin Therapy in Patients with Type 2 Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ole Torffvit ◽  
Majid Kalani ◽  
Jan Apelqvist ◽  
Björn Eliasson ◽  
Jan W. Eriksson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Physiological Saline ◽  
Diabetic Patients ◽  
Size Selectivity ◽  
Type 2 Diabetic Patients ◽  
Once Daily ◽  
Urinary Levels ◽  
Glomerular Size ◽  
Type 2 Diabetic

Fifty-four type 2 diabetic patients with neuroischemic foot ulcers were randomised to treatment with 5000 IU of dalteparin, (n=28), or physiological saline, (n=26), once daily until ulcer healing or for a maximum of 6 months. Thirty-three patients had normo-, 15 micro-, and 6 macroalbuminuria. The urinary levels of IgM and IgG2were elevated in 47 and 50 patients, respectively. Elevated urinary levels of IgM and IgG2indicate decreased glomerular size selectivity. Urine IgM levels were associated with IGF-1/IGFBP-1 and IGFBP-1 levels. Dalteparin treatment increased urinary levels of glycosaminoglycans (P<0.001) and serum IGFBP-1 (P<0.05) while no significant effects were seen in any of the other studied parameters. In conclusion, dalteparin therapy in patients with type 2 diabetes had no effects on urinary levels of albumin, IgM, or IgG2despite significantly increased glycosaminoglycans in urine. Elevated urinary levels of IgM and IgG2might be more sensitive markers of renal disease than albuminuria in patients with type 2 diabetes and antihypertensive therapy.

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