Authors (including presenting author) :
Chow MS, Yip LF, Chan SOY
Affiliation :
Diabetes Care Centre, Princess Margret Hospital
Keyword 1: :
Insulin therapy
Keyword 2: :
Insulin resistance
Keyword 3: :
Type 2 Diabetes patient
Introduction :
Psychological insulin resistance (PIR) is a significant barrier to timely insulin initiation in patients with Type 2 Diabetes Mellitus (T2DM) and oral antidiabetic drug (OAD) failure, potentially delaying optimal glycemic control and increase risk of DM complications. This reluctance is multifaceted including misconception on insulin and disease progression, interference by others, fear of social stigma, pain and hypoglycaemia.
Objectives :
To assess the effectiveness of a structured educational intervention to transform insulin reluctance into acceptance in local setting.
Methodology :
A pre-post evaluation design was employed. Thirteen adult T2DM patients, age from 49 to 73 (61.1+/- 6.5), with OAD failure (HbA1c ≥8% on maximum OADs) were recruited. The multi-component interventions comprised a group session with education, video, peer sharing, and insulin device demonstration, supplemented by pamphlets. This was followed by an individual interview at 4-week, telephone follow-ups at 8-week and 12-week. The primary outcome was change in PIR, measured using the validated Chinese Version of the Insulin Treatment Appraisal Scale for Hong Kong (C-ITAS-HK). Data was analyzed using SPSS.
Result & Outcome :
Results: The programme was started from September 2025 and 13 participants were recruited. Amount 13 participants, 6 (46.2%) participants completed the programme as at January 2026. The pre - post C-ITAS-HK score changed from 68.17(pre mean) to 49.67(post mean), mean difference was -18.5(p=0.042). 5 (38.5%) initiated insulin therapy. 3 participants achieved substantial glycemic improvement, reducing HbA1c from 8.1%, 10.2% and 12.4% to 6.7%, 5.8% and 6.8% respectively. 3 participants remained neutral, while 2 continued to refuse insulin. The findings suggested a reduction in negative perceptions towards insulin treatment following the program. Preliminary results indicated a positive shift in insulin appraisal post-intervention Conclusion: This pilot program demonstrates promise in addressing PIR and facilitating insulin acceptance. The structured, culturally tailored educational approach appears feasible and contribute to improve clinical outcomes. The mixed response underscores the complexity of PIR and highlights the need for individualized, persistent support. Further research with a larger sample and controlled design is warranted to confirm efficacy and refine intervention strategies.
