Insulin Adherence in Type 2 Diabetes in Mexico: Behaviors and Barriers

J Diabetes Res. 2018 Jul 15:2018:3190849. doi: 10.1155/2018/3190849. eCollection 2018.

Abstract

Objective: To investigate factors associated with insulin adherence in subjects with type 2 diabetes mellitus (T2D) attending a tertiary care centre in Mexico City.

Material and methods: Cross-sectional study, including 200 patients. Adherence to insulin therapy was measured with a medication adherence questionnaire. Sociodemographic data and factors related to insulin omission were collected and compared between the nonadherent and adherent groups.

Results: We categorized 117 (58.5%) patients as nonadherent and 83 (41.5%) as adherent. Among the adherent, only 22 patients (11%) had excellent adherence to insulin therapy. The following factors were associated with nonadherence: lack of planning of daily activities (46.1%), fear of hypoglycemia (41%), economic factors (15.4%), and number of insulin applications (2.31 versus 1.76 applications per day).

Conclusions: In this study, patients with type 2 diabetes attending a tertiary care referral centre showed inadequate adherence to insulin therapy. The principal factors associated with insulin omission were low socioeconomic status, fear of hypoglycemia, and a greater number of insulin applications per day.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Attitude to Health
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Female
  • Health Behavior*
  • Humans
  • Hypoglycemia / prevention & control
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / blood
  • Insulin / therapeutic use*
  • Linear Models
  • Male
  • Medication Adherence*
  • Mexico / epidemiology
  • Middle Aged
  • Patient Education as Topic
  • Patient Participation
  • Social Class
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Hypoglycemic Agents
  • Insulin