Perceptions of insulin therapy amongst Asian patients with diabetes in Singapore

S. Wong, J. Lee, Y. Ko, M. F. Chong, C. K. Lam, W. E. Tang

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Aims The objective of this study was to determine the prevalence of insulin refusal amongst Singaporean patients with Type 2 diabetes mellitus, to compare perceptions regarding insulin therapy use between patients who were willing to use insulin and those who were not and to identify demographic factors that might predict insulin refusal.Methods A cross-sectional interviewer-administered survey incorporating demographic variables and 17 perceptions regarding insulin use (14 negative and three positive) was conducted among a sample of 265 patients attending a public primary healthcare centre.Results Seven of every 10 patients expressed unwillingness to use insulin therapy (70.6%). The greatest differences in perceptions between patients willing to use insulin therapy and those who were not included fear of not being able to inject insulin correctly (47.4 vs. 70.6%), fear of pain (44.9 vs. 65.8%), belief that insulin therapy would make it difficult to fulfil responsibilities at work and home (46.2 vs. 66.8%) and belief that insulin therapy improved diabetes control (82.1 vs. 58.3%). A tertiary level of education was associated with willingness to use insulin (odds ratio 3.3, confidence interval 1.8-6.1), and significant differences in perceptions were present in patients with different educational levels.Conclusions Insulin refusal is an important problem amongst our patients with Type 2 diabetes mellitus. Findings of this study suggest that interventions aimed at increasing insulin therapy use should focus on injection-related concerns, perceived lifestyle adaptations and correction of misconceptions. Different interventions may also be required for patients of different educational groups.

Original languageEnglish
Pages (from-to)206-211
Number of pages6
JournalDiabetic Medicine
Volume28
Issue number2
DOIs
Publication statusPublished - Feb 2011
Externally publishedYes

Fingerprint

Singapore
Insulin
Therapeutics
Type 2 Diabetes Mellitus
Fear
Demography
Life Style
Primary Health Care
Odds Ratio

Keywords

  • Asian diabetes
  • Insulin therapy
  • Patient experience
  • Primary care
  • Questionnaire

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Perceptions of insulin therapy amongst Asian patients with diabetes in Singapore. / Wong, S.; Lee, J.; Ko, Y.; Chong, M. F.; Lam, C. K.; Tang, W. E.

In: Diabetic Medicine, Vol. 28, No. 2, 02.2011, p. 206-211.

Research output: Contribution to journalArticle

Wong, S. ; Lee, J. ; Ko, Y. ; Chong, M. F. ; Lam, C. K. ; Tang, W. E. / Perceptions of insulin therapy amongst Asian patients with diabetes in Singapore. In: Diabetic Medicine. 2011 ; Vol. 28, No. 2. pp. 206-211.
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abstract = "Aims The objective of this study was to determine the prevalence of insulin refusal amongst Singaporean patients with Type 2 diabetes mellitus, to compare perceptions regarding insulin therapy use between patients who were willing to use insulin and those who were not and to identify demographic factors that might predict insulin refusal.Methods A cross-sectional interviewer-administered survey incorporating demographic variables and 17 perceptions regarding insulin use (14 negative and three positive) was conducted among a sample of 265 patients attending a public primary healthcare centre.Results Seven of every 10 patients expressed unwillingness to use insulin therapy (70.6{\%}). The greatest differences in perceptions between patients willing to use insulin therapy and those who were not included fear of not being able to inject insulin correctly (47.4 vs. 70.6{\%}), fear of pain (44.9 vs. 65.8{\%}), belief that insulin therapy would make it difficult to fulfil responsibilities at work and home (46.2 vs. 66.8{\%}) and belief that insulin therapy improved diabetes control (82.1 vs. 58.3{\%}). A tertiary level of education was associated with willingness to use insulin (odds ratio 3.3, confidence interval 1.8-6.1), and significant differences in perceptions were present in patients with different educational levels.Conclusions Insulin refusal is an important problem amongst our patients with Type 2 diabetes mellitus. Findings of this study suggest that interventions aimed at increasing insulin therapy use should focus on injection-related concerns, perceived lifestyle adaptations and correction of misconceptions. Different interventions may also be required for patients of different educational groups.",
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