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A Journal on Endocrine System Diseases

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Minerva Endocrinologica 2000 September-December;25(3-4):61-8

language: Italian

Attitudes towards insulin prescription in type 2 diabetic patients non-compliant with diet therapy

Mordenti F., D'Angiolini G., Murgia F.


Background. Investigate the compliance of type 2 diabetic patients with the prescription of insulin according to pre-existing ideas on insulin, and to personality traits.
Methods. Twenty insulin-treated type 2 diabetic patients were selected on the basis of previous scarce compliance with diet and exercise and BMI >28kg/m2 .The patients' attitudes toward insulin prescription were evaluated with a semi-structured interview and personality traits were evaluated with the ACL test(Adjective Check List).
Results. When insulin was first prescribed to these patients, 65% accepted immediately. However, 45% answered that their acquiescence to insulin treatment was accompanied by doubts or apprehension. The fear of insulin dependence was shared by 50%, with a much greater prevalence among those who resisted to insulin treatment (86% vs 31%) and those who recalled doubts and fears about insulin (73% vs 22%). Patients with a fear of dependence differed significantly from the others in five personality scales: greater opposition and ambiguity, less self-confidence, more inflexible, less demanding of others and more inclined to bargain.
Conclusions. The irrational fear of dependence may, therefore, play a role in both the manifest acceptance/rejection of insulin and non-expressed doubts, and may in turn be influenced by personality traits. Specific patient education on insulin treatment in type 2 diabetes is necessary, and should be planned according to the personality factors that may influence the perception of facts and the patients' motivation.

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