“Unveiling Insulin Fear: Awareness, Myths and Practices Surrounding Injectable Insulin among working women suffering from Type 2 Diabetes Mellitus”
Authors: Ali Syed Rohan , Imran Aabir , Haider Aaila , Mehtab Kiran , Anees Muneeba , Haq Muhammad Hammad ul , Umer Muhammad , Khan Sawera , Athar Kainat , Hasan Muhammad 
Published: July 2024

Objective

This study aims to investigate the factors contributing to the reluctance in initiating and continuing insulin therapy among working women diagnosed with type 2 diabetes mellitus in karachi.

Background

A significant number of patients with type 2 diabetes do not achieve adequate control with maximum oral treatments. Early introduction of insulin has been shown to reduce diabetes-related complications. The purpose of this research is to assess the demographic characteristics, clinical factors, and attitudes of type 2 diabetes patients towards initiating insulin therapy. Currently, there is limited data available on insulin therapy for diabetes patients, particularly in Karachi. Therefore, additional randomized and prospective clinical trials are necessary to expand our knowledge and enable healthcare providers to make informed treatment decisions for diabetic patients in this region. Notably, there are various misconceptions surrounding insulin therapy, leading to refusal and delayed initiation, presenting a challenge to healthcare providers. Psychological insulin resistance is also prevalent among diabetic patients, hindering insulin therapy initiation and adherence.

Methods

A cross-sectional study will be conducted, involving a sample size of 167 diabetic female patients, determined using RAOSOFT software based on an estimated population size of 200,000. The sample will be selected through non-probability purposive sampling from Darul Sehat Hospital and healthcare clinics within an 8-month period from November 2023 to July 2024. Informed verbal consent will be obtained from each patient, and the validity of the questionnaire will be assessed. Data will be collected using a structured questionnaire distributed by the researcher. Statistical analysis will be performed using SPSS Version 22 with a 95% confidence interval, 5% margin of error, and a significance level set at 0.05. The relationship between insulin usage and demographic characteristics and clinical data will be evaluated using the χ2 or t-test and logistic regression, with age, educational status, religion, type of job, and diabetes control history as potential effect modifiers.

Result

The data highlights increasing insulin use with disease progression (p = 0.002) and its association with higher education (p = 0.003), indicating awareness. Challenges like injection discomfort among older patients (p = 0.004) and cultural beliefs affecting insulin use (p = 0.005) underscore the need for targeted education and support.

Conclusion

The findings of this study reveal that factors contributing to insulin noncompliance among patients with type 2 diabetes include illiteracy, non-diabetic treatment regimens, misconceptions, no private place for women, fear of cameras. Unhygienic environment. and irrational fear of insulin injections, medication costs, availability issues, concerns about long-term use, lack of family support, poor patient health, infrequent medical visits, and challenges related to communication and monitoring blood glucose levels.