Evaluation of Insulin Prescribing Patterns and Associated Burden among Ambulatory Diabetic Patients in Islamabad/Rawalpindi
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Abstract
Background: Diabetes Mellitus (DM) is a significant global health challenge, particularly in developing countries where it is prevalent and associated with high morbidity and mortality due to poor management and adherence to therapy. In Islamabad/Rawalpindi, the management of DM is compromised by gaps in knowledge and adherence regarding insulin use, which is crucial for effective disease control.
Objective: This study aims to assess the patterns of insulin usage, adherence to therapy, and the impact of educational status on insulin management among patients with diabetes in Islamabad/Rawalpindi.
Methods: A cross-sectional, descriptive, survey-based study was conducted from February to May 2023 among 240 ambulatory diabetic patients. Data were collected using structured questionnaires covering demographics, insulin usage patterns, adherence behaviors, and diabetes management knowledge. Statistical analysis was performed using SPSS version 25, employing descriptive statistics and Chi-Square tests to explore associations between variables.
Results: The majority of participants (52.5%) were over 40 years old, with 55% having type 2 diabetes. Insulin pens were used by 47.1% of the participants, while 50% used syringes. Approximately 66.3% of the participants were also taking oral anti-diabetic medications. About 63.7% regularly attended routine checkups, 88.3% knew how to inject insulin, and 90.8% were aware of the timing for insulin injections. Educational interventions showed a significant impact on adherence and knowledge, with 77.5% demonstrating an understanding of diabetes.
Conclusion: The study highlights the need for improved diabetes education and access to advanced insulin delivery methods to enhance adherence and management of diabetes in Islamabad/Rawalpindi. Emphasizing patient education on insulin use could lead to better disease outcomes and quality of life for diabetic patients in the region.
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References
Shrestha HK, Tamrakar R, Shrestha A, Amatya SR. Insulin Prescription Pattern Among Type 2 DM Patients Visiting Outpatient Department at a Tertiary Hospital in Kathmandu, Nepal. J Diabetes Endocrinol Assoc Nepal. 2017;1(1):3–7.
Alberti KGMM. The Classification and Diagnosis of Diabetes Mellitus. Textb Diabetes. 2010;24–30.
Martinez L, Consoli SM, Monnier L, Simon D, Wong O, Yomtov B, et al. Studying the Hurdles of Insulin Prescription (SHIP©): Development, Scoring, and Initial Validation of a New Self-Administered Questionnaire. Health Qual Life Outcomes. 2007;5:1–11.
Mariye T, Girmay A, Birhanu T, Tasew H, Teklay G, Baraki Z, et al. Adherence to Insulin Therapy and Associated Factors Among Patients With Diabetes Mellitus in Public Hospitals of Central Zone of Tigray, Ethiopia, 2018: A Cross-Sectional Study. Pan Afr Med J. 2019;33(1).
Ogbera AO, Kuku SF. Insulin Use, Prescription Patterns, Regimens, and Costs: A Narrative From a Developing Country. Diabetol Metab Syndr. 2012;4:1–6.
Perez-Nieves M, Boye KS, Kiljanski J, Cao D, Lage MJ. Adherence to Basal Insulin Therapy Among People With Type 2 Diabetes: A Retrospective Cohort Study of Costs and Patient Outcomes. Diabetes Ther. 2018;9:1099–111.
Baynes HW. Classification, Pathophysiology, Diagnosis, and Management of Diabetes Mellitus. J Diabetes Metab. 2015;6(5):1–9.
World Health Organization. Classification of Diabetes Mellitus. 2019.
Mayfield J. Diagnosis and Classification of Diabetes Mellitus: New Criteria. Am Fam Physician. 1998;58(6):1355–62.
Solis-Herrera C, Triplitt C, Reasner C, DeFronzo RA, Cersosimo E. Classification of Diabetes Mellitus. 2015.
Kerner W, Brückel J. Definition, Classification, and Diagnosis of Diabetes Mellitus. Exp Clin Endocrinol Diabetes. 2014;122(07):384–6.
Punthakee Z, Goldenberg R, Katz P. Definition, Classification, and Diagnosis of Diabetes, Prediabetes, and Metabolic Syndrome. Can J Diabetes. 2018;42–5.
Olamoyegun MA, Akinlade AT, Ala OA. Audit of Insulin Prescription Patterns and Associated Burden Among Diabetics in a Tertiary Health Institution in Nigeria. Afr Health Sci. 2018;18(4):852–64.
Katsarou A, Gudbjörnsdottir S, Rawshani A, Dabelea D, Bonifacio E, Anderson BJ, et al. Type 1 Diabetes Mellitus. Nat Rev Dis Prim. 2017;3(1):1–17.
Raveendran AV, Chacko EC, Pappachan JM. Non-Pharmacological Treatment Options in the Management of Diabetes Mellitus. Eur Endocrinol. 2018;14(2):31.
CM R. Management of Blood Glucose in Type 2 Diabetes Mellitus. Am Fam Physician. 2009;79:29–36.
Modi P, Mihic M, Lewin A. The Evolving Role of Oral Insulin in the Treatment of Diabetes Using a Novel RapidMistTM System. Diabetes Metab Res Rev. 2002;18(S1)–42.
Chefik FH, Tadesse TA, Quisido BJE, Roba AE. Adherence to Insulin Therapy and Associated Factors Among Type 1 and Type 2 Diabetic Patients on Follow-Up in Madda Walabu University Goba Referral Hospital, South East Ethiopia. PLoS One. 2022;17(6).
Sarbacker GB, Urteaga EM. Adherence to Insulin Therapy. Diabetes Spectr Publ Am Diabetes Assoc. 2016;29(3):166.
Kaloti AS, Kadian J, Garg A, Garg R, Garg V. A Study of the Knowledge of Diabetes Mellitus in the Patients of Diabetes Mellitus in Karnal, Haryana. Age (Omaha). 56:12–34.
Farsaei S, Radfar M, Heydari Z, Abbasi F, Qorbani M. Insulin Adherence in Patients With Diabetes: Risk Factors for Injection Omission. Prim Care Diabetes. 2014;8(4):338–45.
Association WM. Ethical Principles for Medical Research Involving Human Subjects. Eur J Emerg Med Off J Eur Soc Emerg Med. 2001;8(3):221–3.
Frid AH, Hirsch LJ, Menchior AR, Morel DR, Strauss KW. Worldwide Injection Technique Questionnaire Study: Population Parameters and Injection Practices. In: Mayo Clinic Proceedings. Elsevier; 2016. p. 1212–23.
Polinski JM, Kim SC, Jiang D, Hassoun A, Shrank WH, Cos X, et al. Geographic Patterns in Patient Demographics and Insulin Use in 18 Countries, A Global Perspective From the Multinational Observational Study Assessing Insulin Use: Understanding the Challenges Associated With Progression of Therapy (MOSAIc). BMC Endocr Disord. 2015;15:1–9.