Correlates of Insulin Injection Omission

Overview

Journal Diabetes Care

Specialty Endocrinology

Date 2010 Jan 28

PMID 20103556

Citations 176

Authors

Mark Peyrot

Richard R Rubin

Davida F Kruger

Luther B Travis

Affiliations

Soon will be listed here.

Abstract

Objective: The purpose of this study was to assess factors associated with patient frequency of intentionally skipping insulin injections.

Research Design And Methods: Data were obtained through an Internet survey of 502 U.S. adults self-identified as taking insulin by injection to treat type 1 or type 2 diabetes. Multiple regression analysis assessed independent associations of various demographic, disease, and injection-specific factors with insulin omission.

Results: Intentional insulin omission was reported by more than half of respondents; regular omission was reported by 20%. Significant independent risk factors for insulin omission were younger age, lower income and higher education, type 2 diabetes, not following a healthy diet, taking more daily injections, interference of injections with daily activities, and injection pain and embarrassment. Risk factors differed between type 1 and type 2 diabetic patients, with diet nonadherence more prominent in type 1 diabetes and age, education, income, pain, and embarrassment more prominent in type 2 diabetes.

Conclusions: Whereas most patients did not report regular intentional omission of insulin injections, a substantial number did. Our findings suggest that it is important to identify patients who intentionally omit insulin and be aware of the potential risk factors identified here. For patients who report injection-related problems (interference with daily activities, injection pain, and embarrassment), providers should consider recommending strategies and tools for addressing these problems to increase adherence to prescribed insulin regimens. This could improve clinical outcomes.

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References

Paes A, Bakker A . Impact of dosage frequency on patient compliance. Diabetes Care. 1997; 20(10):1512-7. DOI: 10.2337/diacare.20.10.1512. View

Nathan D, Buse J, Davidson M, Ferrannini E, Holman R, Sherwin R . Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2008; 32(1):193-203. PMC: 2606813. DOI: 10.2337/dc08-9025. View

Gonzalez J, Peyrot M, McCarl L, Collins E, Serpa L, Mimiaga M . Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care. 2008; 31(12):2398-403. PMC: 2584202. DOI: 10.2337/dc08-1341. View

Peyrot M, Skovlund S, Landgraf R . Epidemiology and correlates of weight worry in the multinational Diabetes Attitudes, Wishes and Needs study. Curr Med Res Opin. 2009; 25(8):1985-93. DOI: 10.1185/03007990903073654. View

Lin E, Katon W, Von Korff M, Rutter C, Simon G, Oliver M . Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care. 2004; 27(9):2154-60. DOI: 10.2337/diacare.27.9.2154. View

Anderson R, Skovlund S, Marrero D, Levine D, Meadows K, Brod M . Development and validation of the insulin treatment satisfaction questionnaire. Clin Ther. 2004; 26(4):565-78. DOI: 10.1016/s0149-2918(04)90059-8. View

Mollema E, Snoek F, Pouwer F, Heine R, VAN DER Ploeg H . Diabetes Fear of Injecting and Self-Testing Questionnaire: a psychometric evaluation. Diabetes Care. 2000; 23(6):765-9. DOI: 10.2337/diacare.23.6.765. View

Cramer J, Pugh M . The influence of insulin use on glycemic control: How well do adults follow prescriptions for insulin?. Diabetes Care. 2004; 28(1):78-83. DOI: 10.2337/diacare.28.1.78. View

Martinez L, Consoli S, Monnier L, Simon D, Wong O, Yomtov B . Studying the Hurdles of Insulin Prescription (SHIP): development, scoring and initial validation of a new self-administered questionnaire. Health Qual Life Outcomes. 2007; 5:53. PMC: 2042975. DOI: 10.1186/1477-7525-5-53. View

10.

Link B, Phelan J, Miech R, Westin E . The resources that matter: fundamental social causes of health disparities and the challenge of intelligence. J Health Soc Behav. 2008; 49(1):72-91. DOI: 10.1177/002214650804900106. View

11.

Rubin R . Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med. 2005; 118 Suppl 5A:27S-34S. DOI: 10.1016/j.amjmed.2005.04.012. View

12.

Snoek F, Skovlund S, Pouwer F . Development and validation of the insulin treatment appraisal scale (ITAS) in patients with type 2 diabetes. Health Qual Life Outcomes. 2007; 5:69. PMC: 2241589. DOI: 10.1186/1477-7525-5-69. View

13.

Morris A, Boyle D, McMahon A, Greene S, MacDonald T, Newton R . Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus. The DARTS/MEMO Collaboration. Diabetes Audit and Research in Tayside Scotland. Medicines Monitoring Unit. Lancet. 1997; 350(9090):1505-10. DOI: 10.1016/s0140-6736(97)06234-x. View

14.

Wagner T, Heisler M, Piette J . Prescription drug co-payments and cost-related medication underuse. Health Econ Policy Law. 2008; 3(Pt 1):51-67. DOI: 10.1017/S1744133107004380. View

15.

Olmsted M, Colton P, Daneman D, Rydall A, Rodin G . Prediction of the onset of disturbed eating behavior in adolescent girls with type 1 diabetes. Diabetes Care. 2008; 31(10):1978-82. PMC: 2551638. DOI: 10.2337/dc08-0333. View

16.

Mollema E, Snoek F, Ader H, Heine R, VAN DER Ploeg H . Insulin-treated diabetes patients with fear of self-injecting or fear of self-testing: psychological comorbidity and general well-being. J Psychosom Res. 2001; 51(5):665-72. DOI: 10.1016/s0022-3999(01)00229-x. View

17.

Peyrot M, Rubin R . Persistence of depressive symptoms in diabetic adults. Diabetes Care. 1999; 22(3):448-52. DOI: 10.2337/diacare.22.3.448. View

18.

Peyrot M, Rubin R . Behavioral and psychosocial interventions in diabetes: a conceptual review. Diabetes Care. 2007; 30(10):2433-40. DOI: 10.2337/dc07-1222. View

19.

Gonzalez J, Safren S, Cagliero E, Wexler D, Delahanty L, Wittenberg E . Depression, self-care, and medication adherence in type 2 diabetes: relationships across the full range of symptom severity. Diabetes Care. 2007; 30(9):2222-7. PMC: 4440862. DOI: 10.2337/dc07-0158. View

20.

Rubin R, Knowler W, Ma Y, Marrero D, Edelstein S, Walker E . Depression symptoms and antidepressant medicine use in Diabetes Prevention Program participants. Diabetes Care. 2005; 28(4):830-7. PMC: 1314970. DOI: 10.2337/diacare.28.4.830. View