|Rejection of insulin therapy among patients with type 2 diabetes in China: reasons and recommendations|
|Xiong Zhenzhen1; Yuan Li1; Guo Xiaohui2; Lou Qingqing3; Zhao Fang4; Shen Li5; Zhang Mingxia6; Sun Zilin7|
|关键词||diabetes mellitus, type 2 insulin drug therapy rejection|
|刊名||CHINESE MEDICAL JOURNAL|
|WOS标题词||Science & Technology|
|类目[WOS]||Medicine, General & Internal|
|研究领域[WOS]||General & Internal Medicine|
|关键词[WOS]||GLYCEMIC CONTROL ; SELF-MANAGEMENT ; PATIENTS FEARS ; RESISTANCE ; MELLITUS ; UK ; COMPLICATIONS ; POPULATION ; EFFICACY ; GLUCOSE|
Background Insulin injection therapy is one of the most effective treatments for type 2 diabetes mellitus (T2DM). Many people with T2DM in western countries resist starting insulin therapy; whether the same is true in China is unknown. This survey-based study assessed acceptance and rejection of insulin therapy among individuals with T2DM in China and self-reported reasons for these therapy choices. It also examined what methods may be useful for increasing the rate of insulin acceptance.
Methods A multi-center, cross-sectional survey was conducted between April and July 2010 to a convenience sample of inpatients and outpatients at 50 medical centers across 29 administrative divisions in China. Data were collected on sociodemographic and T2DM characteristics, therapy regime, and attitudes toward insulin therapy.
Results A total of 6 043 patients were surveyed, and 5 961 complete questionnaires (98.6%) were used in the analysis. Just over half the respondents (3 460, 58.0%) reported negative attitudes to insulin therapy, including 2 508 of the 4 469 patients (56.1%) whose physicians had recommended it to them. Of the patients counseled to use insulin, 800 (17.9%) were unwilling to start therapy and cited the following reasons: inconvenience (64.3%); concerns over addiction (24.6%); pain (14.3%); side effects (14.1%); and high cost (13.6%). Logistic regression suggested that respondents would be more willing to undertake insulin therapy if they had received diabetes education, had positive attitudes to the treatment, had higher glycosylated hemoglobin level, or had suffered diabetes for a longer period or with more complications.
Conclusions Patients with T2DM in China are often resistant to insulin therapy if they have been diagnosed with the disease for a relatively short time or if the disease has been relatively mild. Educating patients on the benefits of insulin therapy, not only at the initial diagnosis with T2DM but also when insulin therapy becomes necessary, will likely increase their willingness to undertake it.
|作者单位||1.Sichuan Univ, Dept Endocrinol, West China Hosp, Chengdu 610041, Sichuan, Peoples R China|
2.Beijing Tsinghua Hosp, Beijing 102218, Peoples R China
3.Peking Univ, Dept Endocrinol, Hosp 1, Beijing 100034, Peoples R China
4.Jiangsu Prov Integrated Chinese & Western Med Hos, Dept Hlth Educ, Nanjing 210028, Jiangsu, Peoples R China
5.China Japan Friendship Hosp, Dept Endocrinol, Beijing 100029, Peoples R China
6.Peking Univ, Peoples Hosp, Dept Endocrinol, Beijing 100034, Peoples R China
7.Southeast Univ, Zhongda Hosp, Dept Internal Med, Nanjing 210009, Jiangsu, Peoples R China
|Xiong Zhenzhen,Yuan Li,Guo Xiaohui,et al. Rejection of insulin therapy among patients with type 2 diabetes in China: reasons and recommendations[J]. CHINESE MEDICAL JOURNAL,2014,127(20):3530-3536.|
|APA||Xiong Zhenzhen.,Yuan Li.,Guo Xiaohui.,Lou Qingqing.,Zhao Fang.,...&Sun Zilin.(2014).Rejection of insulin therapy among patients with type 2 diabetes in China: reasons and recommendations.CHINESE MEDICAL JOURNAL,127(20),3530-3536.|
|MLA||Xiong Zhenzhen,et al."Rejection of insulin therapy among patients with type 2 diabetes in China: reasons and recommendations".CHINESE MEDICAL JOURNAL 127.20(2014):3530-3536.|