Why do some people with type 2 diabetes who are using insulin have poor glycaemic control? A qualitative study

BMJ Open. 2015 Jan 29;5(1):e006407. doi: 10.1136/bmjopen-2014-006407.

Abstract

Objective: To explore factors influencing poor glycaemic control in people with type 2 diabetes using insulin.

Research design: A qualitative method comprising in-depth individual interviews. A semistructured interview guide was used. The interviews were audiorecorded, transcribed verbatim and analysed using a thematic approach.

Participants: Seventeen people with type 2 diabetes using insulin with glycated haemoglobin (HbA1c) ≥9% for >1 year.

Setting: The Primary Care Clinic and Diabetes Clinic in the University of Malaya Medical Centre (UMMC), Malaysia.

Results: Data analysis uncovered four themes: lifestyle challenges in adhering to medical recommendations; psychosocial and emotional hurdles; treatment-related factors; lack of knowledge about and self-efficacy in diabetes self-care.

Conclusions: Factors that explain the poor glycaemic control in people with type 2 diabetes using insulin were identified. Healthcare providers could use these findings to address patients' concerns during consultations and help to improve glycaemic control.

Keywords: PREVENTIVE MEDICINE; PRIMARY CARE; PUBLIC HEALTH; SOCIAL MEDICINE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / psychology
  • Female
  • Glycated Hemoglobin / analysis
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use*
  • Life Style
  • Malaysia
  • Male
  • Medication Adherence / psychology
  • Middle Aged
  • Qualitative Research
  • Risk Factors
  • Self Care / psychology
  • Self Efficacy
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin