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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Main Authors: Engemadzo Bitsang, Billy M. Tsima, Keneilwe Motlhatlhedi
Format: Article
Language:English
Published: AOSIS 2025-04-01
Series:African Journal of Primary Health Care & Family Medicine
Subjects:
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.
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2071-2936
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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
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AT keneilwemotlhatlhedi psychologicalinsulinresistanceamongpatientswithdiabetesmellitusinbotswana