Title: Assessment of psychological insulin resistance in patients on insulin therapy

Authors: Kawiraj.N, Viswanathan.K. N, Prem Kumar.G, Vivekraj.N

 DOI: https://dx.doi.org/10.18535/jmscr/v11i2.09

Abstract

Introduction

Diabetes mellitus (DM) currently affects 415 million people worldwide, which is expected to increase to 642 million by the year 2040.The pathology behind is attributed to reduced insulin secretion, absence of an insulin effect, or both. Many diabetic patients are diagnosed on the basis of symptoms such as polyuria, polydipsia, and weight loss. Diagnosis is achieved by identification of elevated blood glucose levels, however in most instances it is the diabetes-related health problems that allow a diagnosis. Many international guidelines have recommended the early initiation of insulin therapy. But, Even with well-established effectiveness of insulin in the treatment of diabetes, several factors play a role in delay in the initiation of insulin treatment naïve patient and the poor adherence to the insulin in treated patients. This occurs due to the false perceptions regarding the insulin among the diabetic population. Psychological insulin resistance (PIR) refers to the negative attitude and beliefs towards insulin. It Is a multifactorial concept involving the patient’s beliefs and knowledge about insulin, negative perceptions and attitudinal barriers, lifestyle adaptations, social stigmata and the fear of side effects or complications. ITAS (Insulin treatment appraisal scale) is a 20 point questionnaire  which measures both positive and negative aspects of insulin therapy.1

References

  1. Snoek, F.J., Skovlund, S.E. &Pouwer, F. Development and validation of the insulin treatment appraisal scale (ITAS) in patients with type 2 diabetes. Health Qual Life Outcomes 5, 69 (2007).
  2. Polonsky W, Fisher L, Guzman S, Villa-Caballero L, Edelman S. Psychological Insulin Resistance in Patients With Type 2 Diabetes: The scope of the problem. Diabetes Care. 2005;28(10):2543-2545.
  3. Ku EJ, Lee DH, Jeon HJ, Park F, Oh TK. Psychometric Analysis Regarding the Barriers to Providing Effective Insulin Treatment in Type 2 Diabetic Patients. Diabetes Ther. 2021 Jan;12(1):159-170. doi: 10.1007/s13300-020-00947-2. Epub 2020 Oct 24.
  4. Jha S, Panda M, Kumar S, Gupta R, Neemani A, Jacob J, Thomas NM, James A, Waghdhare S, Agarwal G. Psychological Insulin Resistance in Patients with Type 2 Diabetes. The Journal of the Association of Physicians of India. 2015 Jul 1;63(7):33-9

Corresponding Author

Kawiraj.N

Postgraduate, Department of General Medicine

Sri Manakula vinayagar Medical College and Hospital, Pondicherry, India