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Learning Objective 1: The learner will be able to identify the ethnic differences in the barriers to use insulin treatment.
Learning Objective 2: The learners will be able to identify the gender, age, education differences in the barriers to use insulin treatment.
Type 2 diabetes is becoming a worldwide epidemic with prevalence increasing in all ethnic groups. Patients with type 2 diabetes are often reluctant to begin insulin. Current approaches to address reluctance to begin insulin therapy are largely educational. Little research exists, however, to determine which factors are associated with patients’ barriers to use insulin therapy. This study’s purpose was to examine the factor associated with the barriers to insulin treatment in individuals with type 2 diabetes.
Methods:
A cross-sectional descriptive study design was used. Data were collected from 178 people with type 2 diabetes; who were18 years or older; being treated with diabetic oral agents and able to speak English. Participants completed Barriers to Insulin Treatment (BIT) questionnaires.
Results:
Subjects’(n=178) mean age was 64.3±13.5 years and most were female (53.9 %). Participants were Asian (32.6%), White (31.5%), African American (25.3%) and others (10.6%). Women had higher scores in fear of injection (mean difference 4.5) and stigmatization (mean difference 2.8) than men. Asians had significantly higher scores in fear of injection (mean difference 5.45) and expected hardship in using insulin (mean difference 3.98) than Whites. Other minority groups (Hispanics, American Indians and Pacific Islanders) also showed significantly higher scores in fear of injection (mean difference 6.14) than Whites. More educated people were less fearful of hypoglycemia and younger people tended to have more positive expectations regarding insulin treatment and expected greater hardship.
Conclusion: Sociodemographic factors are important in the barriers to insulin treatment. Ethnic minorities have more psychological barriers to insulin treatment. Further research is needed that considers these findings in developing interventions for this large and growing population.