Determination of insulin therapy perceptions in patients with diabetes mellitus and prediabetes attending the diabetes outpatient clinic

TL;DR

The study found that type 1 diabetes patients have more positive views about insulin therapy compared to type 2 diabetes and prediabetes patients.

Contribution

This is the first study to compare insulin perceptions across type 1 diabetes, type 2 diabetes, and prediabetes patients.

Findings

Type 1 diabetes patients had significantly more positive perceptions of insulin therapy than type 2 diabetes and prediabetes patients.

Age, C-peptide levels, and diabetes duration were correlated with insulin therapy perceptions.

Marital status, education level, and blood glucose monitoring influenced insulin perceptions.

Abstract

Negative perceptions of insulin therapy are common in diabetes mellitus (DM) patients and may delay treatment. Insulin perception has been studied in type 2 diabetics but not type 1 or prediabetics. The aim of this study was to determine the differences in perceptions of insulin use between diabetes types.

This cross-sectional study was conducted at a tertiary care hospital between December 2023 and April 2024. Participants were adult diabetes outpatient clinic patients with T1DM, T2DM, or prediabetes. The validated Insulin Therapy Appraisal Scale (ITAS) quantified patients’ insulin therapy perceptions. Patients who did not use insulin and were in the prediabetes category answered the questions based on their current knowledge about insulin treatment. Higher scores on the positive sub-dimension indicate more favorable perceptions of insulin therapy, whereas higher scores on the negative sub-dimension and total ITAS reflect more negative perceptions. p-value < 0.05 was considered statistically significant.

A total of 160 adult patients were included in the study. Patients with T1DM demonstrated significantly higher ITAS positive sub-dimension scores and lower negative sub-dimension and total ITAS scores compared with patients with T2DM and prediabetes (p < 0.05). No significant differences in ITAS scores were observed between the T2DM and prediabetes groups. Correlation analyses showed that the ITAS positive sub-dimension score was inversely associated with age and C-peptide levels. In contrast, negative sub-dimension and total ITAS scores were positively correlated with age and C-peptide levels but negatively correlated with diabetes duration. Marital status, highest education level, and regular blood glucose monitoring were found to significantly influence insulin perception (p < 0.05). Female patients exhibited more positive perceptions, whereas insulin users, patients without diabetes-related complications, and those who exercised regularly demonstrated less negative attitudes toward insulin therapy.

Patients with T1DM have significantly more positive perceptions of insulin therapy compared with patients with T2DM and prediabetes. Identifying factors influencing insulin-related perceptions may help improve acceptance of insulin therapy and enhance treatment adherence in patients with diabetes.

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