Session Title: Poster Session 1
Category: Psychosocial determinants of self-management
Presentation Date: Friday, November 07, 2008
THE PERCEPTION OF INSULIN THERAPY BETWEEN ORAL HYPOGLYCEMIC AGENT-TREATED AND INSULIN-TREATED TYPE 2 DIABETIC PATIENTS IN CHINESE
M.-P. Chang1, C.-Y. Huang2, H.-T. Chiu3, C.-T. Chang2, R.-H. Chen2, T.-Y. Wang2, M.M.-T. Fuh2, W.-L. Huang2, M.-H. Hsieh2, C.-C. Chen2
1National Taichung Nursing College, Department of Nursing, Taichung, Taiwan, Republic of China, 2China Medical University Hospital, Division of Endocrinology and Metabolism, Department of Medicine, Taichung, Taiwan, Republic of China, 3China Medical University, Biostatistics Center, Taichung, Taiwan, Republic of China
Aim: Psychological insulin resistance is a common barrier in patients with type 2 DM. We aim to evaluate the perception of insulin therapy between oral hypoglycemic agent (OHA)-treated and insulin-treated Chinese type 2 diabetic patients.
Method: A total of 200 patients (100 OHA-taking and 100 insulin-treated patients) were recruited consecutively from the outpatient clinic. The Insulin Treatment Appraisal Scale (ITAS) was used to evaluate the perception of insulin therapy. The ITAS has 20 items (16 negative items and 4 positive items) scored on a 5 point Likert scale. For calculation the total score, 4 positive items were reversed to rate. The total score of ITAS was 100. The higher the total ITAS score, the more negative appraisal of insulin therapy.
Results: The blood sugar control of OHA-treated group was better than insulin-treated group (HbA1C 7.9±1.0% vs 8.6±1.5%, p =0.0003). The mean total score of 16 negative items of OHA-treated group was greater than insulin-treated group (52.2±6.5 vs 45.8±6.0, p < 0.001). The mean total score of 4 positive items of OHA-treated group was smaller than insulin-treated group (13.3±2.5 vs 14.7±1.8, p < 0.001). The mean sum of total score of OHA-treated group was greater than insulin-treated group (62.9±7.1 vs 55.0±6.1, p < 0.001).
Conclusion: Patients with type 2 DM who were taking OHA have more negative beliefs and attitudes about insulin therapy than those who were treated with insulin already. We have to provide more education about insulin for OHA-treated patients in order to initiate early insulin therapy.