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Insulin-Naive Patients Demonstrate Psychological Insulin Resistance: Presented at ADA

By Jill Stein

NEW ORLEANS, LA -- June 16, 2003 -- Type 2 diabetes patients who have never been treated with insulin have more negative attitudes about insulin therapy than patients actually treated with insulin, according to a Danish study.

The researchers presented their findings here on June 15^th at the 63^rd Scientific Sessions of the American Diabetes Association.

Soren E. Skovlund, MSc, with Novo Nordisk, in Copenhagen, Denmark, reported the results of a study that compared attitudes and beliefs about insulin therapy in 146 insulin-naive and 136 insulin-treated patients with type 2 diabetes.

Her team used the Insulin Treatment Appraisal Scale (ITAS), which evaluates perceptions toward insulin treatment by examining the response to 20 different statements scored on a 5-point Likert.

Examples of items from the ITAS include "Taking insulin makes me less flexible," "Taking insulin means other people see me as a sicker person," and "Managing insulin injections takes a lot of time and energy."

In the study, insulin-treated patients differed from insulin-naive patients with respect to duration, complications, control, and distress; however, the statistical analysis controlled for these variables.

Results showed that insulin-naive patients perceived insulin therapy significantly more negatively than insulin-treated patients on 17 of the 20 items (P<0.05). Only worry about weight gain was more prominent in the insulin-treated group.

Significantly more insulin-naive patients believed that insulin therapy was demanding in terms of time and energy (61% versus 28%, P<0.0001) and that insulin makes it difficult to carry out responsibilities at work and at home (27% versus 9%, P<0.0001).

Insulin-naive patients reported considerably more self-blame in relation to use of insulin and more concern about hypoglycemia than insulin-treated patients (P<0.001).

Overall, insulin usage was the main predictor of ITAS total score.

"The results suggest that in consultations, the ITAS may be a useful tool for identifying and targeting specific fears or negative beliefs about insulin therapy in patients who need to use such treatment," Ms. Skovlund said.

The study was sponsored by Novo Nordisk.


[Study title: Appraisal of Insulin Therapy among Type 2 Diabetes Patients with and without Previous Experience of Insulin Treatment. Abstract 1818]

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