PMID- 32562245
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 11
IP  - 8
DP  - 2020 Aug
TI  - Key Strategies for Overcoming Psychological Insulin Resistance in Adults with 
      Type 2 Diabetes: The UK Subgroup in the EMOTION Study.
PG  - 1735-1744
LID - 10.1007/s13300-020-00856-4 [doi]
AB  - INTRODUCTION: Many patients with type 2 diabetes mellitus (T2DM) delay initiation 
      of insulin therapy despite healthcare professional (HCP) advice. This phenomenon 
      has been referred to as 'psychological insulin resistance' (PIR), and various 
      contributing factors have been identified. Studies discussing approaches to 
      overcoming PIR are lacking. Our aim was to identify the key strategies used by 
      HCPs that most helped adults with T2DM and PIR in the UK to initiate insulin. 
      METHODS: As part of a global study, UK adults with T2DM and PIR were recruited 
      (N = 125) to take a survey that included 38 HCP statements and actions about 
      insulin initiation. Data assessed were perceived occurrence and helpfulness of 
      these strategies in facilitating insulin initiation. RESULTS: The most helpful 
      strategies involved demonstrating the injection process (e.g. HCP talked patient 
      through the process of taking insulin [83.6%]) and adopting a collaborative 
      approach (HCP encouraged patient to contact the clinic immediately in case of any 
      problems/questions [80.5%]). Additionally, HCPs highlighting the benefits of 
      insulin (HCP explained that insulin was a natural substance needed by patient's 
      body [81.2%]) and allaying patients' concerns (HCP explained that patient might 
      not have to take insulin forever [78.0%]) helped patients initiate insulin. The 
      least helpful action was HCPs repeatedly persuading patients to initiate insulin 
      (40.9%). CONCLUSIONS: The study recommends key strategies that HCPs can adopt to 
      help adults with T2DM overcome PIR in the UK.
FAU - Balogh, Elemer G
AU  - Balogh EG
AD  - Eli Lilly and Company, Basingstoke, UK.
FAU - Perez-Nieves, Magaly
AU  - Perez-Nieves M
AD  - Eli Lilly and Company, Indianapolis, IN, USA. perez_magaly@lilly.com.
FAU - Cao, Dachuang
AU  - Cao D
AD  - Eli Lilly and Company, Indianapolis, IN, USA.
FAU - Hadjiyianni, Irene I
AU  - Hadjiyianni II
AD  - Lilly Deutschland GmbH, Bad Homburg, Germany.
FAU - Ashraf, Nadeem
AU  - Ashraf N
AD  - Eli Lilly and Company, Basingstoke, UK.
FAU - Desai, Urvi
AU  - Desai U
AD  - Analysis Group, Inc., Boston, MA, USA.
FAU - Snoek, Frank J
AU  - Snoek FJ
AD  - Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, Netherlands.
FAU - Sturt, Jackie A
AU  - Sturt JA
AD  - Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's 
      College London, London, UK.
LA  - eng
PT  - Journal Article
DEP - 20200619
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC7376995
OAB - Many patients with type 2 diabetes (T2DM) are reluctant to start insulin therapy 
      despite it being recommended by their doctor. This can lead to a delay in 
      receiving effective treatment to control blood sugar. There are many reasons to 
      explain this reluctance-which is also referred to as psychological insulin 
      resistance (PIR)-including fear of injections and lack of understanding. EMOTION 
      was a global study which set out to identify strategies to overcome PIR. It 
      looked at 38 things, identified by people with diabetes, that doctors/nurses can 
      do or say to encourage a patient to try insulin. Analysis of results for the 125 
      UK patients with T2DM who were reluctant to start insulin showed that the most 
      helpful approach was demonstrating the injection procedure. Actually talking a 
      patient through how to inject insulin and demonstrating how the pen works can 
      help reduce their fears about the injection process. Adopting a collaborative 
      approach was found to be important, encouraging patients to get in touch with any 
      problems or questions. Other helpful strategies included highlighting the 
      benefits of insulin-explaining that it is a natural substance the body needs-and 
      addressing any specific concerns a patient may have about insulin. The least 
      helpful strategy was taking an authoritarian approach and repeatedly trying to 
      persuade a patient to start insulin. This is the first study which provides 
      evidence-based clinical strategies that UK healthcare professionals can use to 
      help overcome PIR in their patients with T2DM.
OABL- eng
OTO - NOTNLM
OT  - Basal insulin
OT  - Healthcare professionals
OT  - Psychological insulin resistance
OT  - Type 2 diabetes mellitus
OT  - UK patients
EDAT- 2020/06/21 06:00
MHDA- 2020/06/21 06:01
PMCR- 2020/06/19
CRDT- 2020/06/21 06:00
PHST- 2020/03/11 00:00 [received]
PHST- 2020/06/21 06:00 [pubmed]
PHST- 2020/06/21 06:01 [medline]
PHST- 2020/06/21 06:00 [entrez]
PHST- 2020/06/19 00:00 [pmc-release]
AID - 10.1007/s13300-020-00856-4 [pii]
AID - 856 [pii]
AID - 10.1007/s13300-020-00856-4 [doi]
PST - ppublish
SO  - Diabetes Ther. 2020 Aug;11(8):1735-1744. doi: 10.1007/s13300-020-00856-4. Epub 
      2020 Jun 19.