Psychological insulin resistance among patients with diabetes mellitus in Botswana
Background: Timely initiation of insulin therapy is vital in patients with type 2 diabetes mellitus. However, insulin initiation may be delayed because of psychological insulin resistance (PIR). Aim: This study aims to determine the prevalence of PIR and factors that contribute to PIR in adults wit...
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| Format: | Article |
| Language: | English |
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AOSIS
2025-04-01
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| Series: | African Journal of Primary Health Care & Family Medicine |
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| Online Access: | https://phcfm.org/index.php/phcfm/article/view/4752 |
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| author | Engemadzo Bitsang Billy M. Tsima Keneilwe Motlhatlhedi |
| author_facet | Engemadzo Bitsang Billy M. Tsima Keneilwe Motlhatlhedi |
| author_sort | Engemadzo Bitsang |
| collection | DOAJ |
| description | Background: Timely initiation of insulin therapy is vital in patients with type 2 diabetes mellitus. However, insulin initiation may be delayed because of psychological insulin resistance (PIR).
Aim: This study aims to determine the prevalence of PIR and factors that contribute to PIR in adults with type 2 diabetes mellitus at a diabetes clinic in Botswana.
Setting: The study was conducted in a diabetes clinic, one of the two large centres in the country that manage diabetes mellitus. It is situated on the south eastern part of Botswana.
Methods: This was a cross-sectional study among patients with type 2 diabetes mellitus. We included participants aged between 18 and 80 years old and diagnosed with type 2 diabetes mellitus for more than 1 year. Patients’ attitudes towards insulin therapy were assessed using the Insulin Treatment Appraisal Scale (ITAS).
Results: The prevalence of PIR was 82.9% (95% confidence interval [CI]: 78.0 – 87.8) out of the 228 respondents. Factors significantly associated with PIR were gender (odds ratio [OR] adjusted 0.44; 95% confidence interval 0.211 – 0.921; p = 0.029) and treatment type (OR adjusted 1.58; 95% confidence interval 1.067 – 2.341; p = 0.023).
Conclusion: Significant factors associated with psychological insulin resistance were patient and health system-related. It is therefore pivotal to improve patient and healthcare provider communication and to ensure that patient education is thoroughly performed at the diagnosis of disease.
Contribution: This study highlights the importance of patient education at diagnosis and during treatment continuum of diabetes mellitus. |
| format | Article |
| id | doaj-art-22096d0452624af2b0e68d85c2585d29 |
| institution | Kabale University |
| issn | 2071-2928 2071-2936 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Primary Health Care & Family Medicine |
| spelling | doaj-art-22096d0452624af2b0e68d85c2585d292025-08-20T03:48:52ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362025-04-01171e1e710.4102/phcfm.v17i1.47521242Psychological insulin resistance among patients with diabetes mellitus in BotswanaEngemadzo Bitsang0Billy M. Tsima1Keneilwe Motlhatlhedi2Ministry of Health, Gaborone, Botswana; and Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, GaboroneDepartment of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, GaboroneDepartment of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, GaboroneBackground: Timely initiation of insulin therapy is vital in patients with type 2 diabetes mellitus. However, insulin initiation may be delayed because of psychological insulin resistance (PIR). Aim: This study aims to determine the prevalence of PIR and factors that contribute to PIR in adults with type 2 diabetes mellitus at a diabetes clinic in Botswana. Setting: The study was conducted in a diabetes clinic, one of the two large centres in the country that manage diabetes mellitus. It is situated on the south eastern part of Botswana. Methods: This was a cross-sectional study among patients with type 2 diabetes mellitus. We included participants aged between 18 and 80 years old and diagnosed with type 2 diabetes mellitus for more than 1 year. Patients’ attitudes towards insulin therapy were assessed using the Insulin Treatment Appraisal Scale (ITAS). Results: The prevalence of PIR was 82.9% (95% confidence interval [CI]: 78.0 – 87.8) out of the 228 respondents. Factors significantly associated with PIR were gender (odds ratio [OR] adjusted 0.44; 95% confidence interval 0.211 – 0.921; p = 0.029) and treatment type (OR adjusted 1.58; 95% confidence interval 1.067 – 2.341; p = 0.023). Conclusion: Significant factors associated with psychological insulin resistance were patient and health system-related. It is therefore pivotal to improve patient and healthcare provider communication and to ensure that patient education is thoroughly performed at the diagnosis of disease. Contribution: This study highlights the importance of patient education at diagnosis and during treatment continuum of diabetes mellitus.https://phcfm.org/index.php/phcfm/article/view/4752diabetes mellituspsychological insulin resistanceinsulin therapyitas scalebotswana |
| spellingShingle | Engemadzo Bitsang Billy M. Tsima Keneilwe Motlhatlhedi Psychological insulin resistance among patients with diabetes mellitus in Botswana African Journal of Primary Health Care & Family Medicine diabetes mellitus psychological insulin resistance insulin therapy itas scale botswana |
| title | Psychological insulin resistance among patients with diabetes mellitus in Botswana |
| title_full | Psychological insulin resistance among patients with diabetes mellitus in Botswana |
| title_fullStr | Psychological insulin resistance among patients with diabetes mellitus in Botswana |
| title_full_unstemmed | Psychological insulin resistance among patients with diabetes mellitus in Botswana |
| title_short | Psychological insulin resistance among patients with diabetes mellitus in Botswana |
| title_sort | psychological insulin resistance among patients with diabetes mellitus in botswana |
| topic | diabetes mellitus psychological insulin resistance insulin therapy itas scale botswana |
| url | https://phcfm.org/index.php/phcfm/article/view/4752 |
| work_keys_str_mv | AT engemadzobitsang psychologicalinsulinresistanceamongpatientswithdiabetesmellitusinbotswana AT billymtsima psychologicalinsulinresistanceamongpatientswithdiabetesmellitusinbotswana AT keneilwemotlhatlhedi psychologicalinsulinresistanceamongpatientswithdiabetesmellitusinbotswana |