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Article: Association of More Negative Attitude towards Commencing Insulin with Lower Glycosylated Hemoglobin (HbA1c) Level: A survey on Insulin-naïve Type 2 Diabetes Mellitus Chinese Patients

TitleAssociation of More Negative Attitude towards Commencing Insulin with Lower Glycosylated Hemoglobin (HbA1c) Level: A survey on Insulin-naïve Type 2 Diabetes Mellitus Chinese Patients
Authors
Issue Date2016
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.jdmdonline.com
Citation
Journal of Diabetes & Metabolic Disorders, 2016, v. 15, article no. 3 How to Cite?
AbstractAims: This study examined the correlation between socio-demographic and clinical characteristics; and attitudes towards commencing insulin in Chinese primary care patients with Type 2 Diabetes Mellitus (DM). Method: A cross-sectional survey was conducted on 303 insulin-naïve Type 2 DM patients recruited from 15 primary care clinics across Hong Kong using the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ). Subject selection criteria were patients on maximal oral anti-diabetes treatment who needed to commence insulin therapy. Linear regression was used to identify correlations between age, sex, educational level, occupation, body mass index, diabetes disease duration, laboratory test indicating disease control and biochemical markers including glycosylated hemoglobin (HbA1c) level , low density lipoprotein level and estimated glomeruli filtration rate, and presence of diabetic complications with the four sub-scales (self-image and stigmatization; factors promoting self-efficacy; fear of pain or needles; time and family support ) and the overall Ch-ASIQ score. Results: The most prevalent negative attitude was ‘fear of needle injections’ (70.1%). The most common positive attitude was ‘I can manage the skill of injecting insulin’ (67.5%). The mean Ch-ASIQ score of 2.50 (S.D.=0.38) was equal to the mid-score, which signified an overall ambivalent attitude among the study population. Women scored significantly higher in the fear of pain or needles subscale (p=0.011) and had an overall more negative attitude towards commencing insulin (p=0.016). Subjects with lower HbA1c levels also had a significantly lower Ch-ASIQ sum score (p=0.048) indicating a more negative attitude towards commencing insulin. Conclusion: In Chinese primary care patients with Type 2 DM, the need to commence insulin was associated with a number of negative emotions, which lead to a lower motivation to accept treatment. Perception of need as indicated by HbA1c level may be an important influencing factor determining a patient’s overall attitude towards starting insulin. Fortunately, in our setting, the injection technique does not appear to be a major barrier. However, needle fears are common, especially amongst women. Target interventions to acknowledge and help them to overcome their fears are essential before insulin treatment is commenced.
Persistent Identifierhttp://hdl.handle.net/10722/223855
ISSN
2015 SCImago Journal Rankings: 0.693
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorFu, SN-
dc.contributor.authorWong, CKH-
dc.contributor.authorChin, WY-
dc.contributor.authorLuk, W-
dc.date.accessioned2016-03-18T02:29:59Z-
dc.date.available2016-03-18T02:29:59Z-
dc.date.issued2016-
dc.identifier.citationJournal of Diabetes & Metabolic Disorders, 2016, v. 15, article no. 3-
dc.identifier.issn2251-6581-
dc.identifier.urihttp://hdl.handle.net/10722/223855-
dc.description.abstractAims: This study examined the correlation between socio-demographic and clinical characteristics; and attitudes towards commencing insulin in Chinese primary care patients with Type 2 Diabetes Mellitus (DM). Method: A cross-sectional survey was conducted on 303 insulin-naïve Type 2 DM patients recruited from 15 primary care clinics across Hong Kong using the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ). Subject selection criteria were patients on maximal oral anti-diabetes treatment who needed to commence insulin therapy. Linear regression was used to identify correlations between age, sex, educational level, occupation, body mass index, diabetes disease duration, laboratory test indicating disease control and biochemical markers including glycosylated hemoglobin (HbA1c) level , low density lipoprotein level and estimated glomeruli filtration rate, and presence of diabetic complications with the four sub-scales (self-image and stigmatization; factors promoting self-efficacy; fear of pain or needles; time and family support ) and the overall Ch-ASIQ score. Results: The most prevalent negative attitude was ‘fear of needle injections’ (70.1%). The most common positive attitude was ‘I can manage the skill of injecting insulin’ (67.5%). The mean Ch-ASIQ score of 2.50 (S.D.=0.38) was equal to the mid-score, which signified an overall ambivalent attitude among the study population. Women scored significantly higher in the fear of pain or needles subscale (p=0.011) and had an overall more negative attitude towards commencing insulin (p=0.016). Subjects with lower HbA1c levels also had a significantly lower Ch-ASIQ sum score (p=0.048) indicating a more negative attitude towards commencing insulin. Conclusion: In Chinese primary care patients with Type 2 DM, the need to commence insulin was associated with a number of negative emotions, which lead to a lower motivation to accept treatment. Perception of need as indicated by HbA1c level may be an important influencing factor determining a patient’s overall attitude towards starting insulin. Fortunately, in our setting, the injection technique does not appear to be a major barrier. However, needle fears are common, especially amongst women. Target interventions to acknowledge and help them to overcome their fears are essential before insulin treatment is commenced.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.jdmdonline.com-
dc.relation.ispartofJournal of Diabetes & Metabolic Disorders-
dc.rightsJournal of Diabetes & Metabolic Disorders. Copyright © BioMed Central Ltd.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleAssociation of More Negative Attitude towards Commencing Insulin with Lower Glycosylated Hemoglobin (HbA1c) Level: A survey on Insulin-naïve Type 2 Diabetes Mellitus Chinese Patients-
dc.typeArticle-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailChin, WY: chinwy@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityChin, WY=rp00290-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s40200-016-0223-0-
dc.identifier.pmid26913243-
dc.identifier.pmcidPMC4765059-
dc.identifier.hkuros257122-
dc.identifier.volume15-
dc.publisher.placeUnited Kingdom-

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