Salah NA1* and Abdelaziz SI2
1Department of Family Medicine, Sudan Medical Specialization Board (SMSB), Sudan 2Department of Internal Medicine and Endocrinology, Soba University Hospital, SudanFulltext PDF
Background: Type 2 Diabetes (T2DM) is mainly characterized by insulin resistance and insulin is the ultimate treatment to lower the level of glucose in the blood. Over the years, insulin has been proven to effectively improve HbA1c. However, there are many barriers to initiation of insulin therapy; here we will discuss physicians’ barriers. Objective: To study barriers to insulin therapy among family medicine doctors in family health care centers in East Nile and Bahri localities, Sudan. Materials and Methods: An observational cross-sectional primary health-care based study carried out between February 2019 and February 2020. Results: The study included 63 participants, the majority was females. 28 (44.4%) strongly agreed that patients benefit from receiving insulin therapy prior to developing complications. 24 (38.1%) stated that insulin therapy should be delayed until necessary, 51 (81.0%) strongly agreed that proper education and training are important for successful initiation of insulin therapy in T2DM. Specialist and participants who attended a workshop or a conference referred patients less to endocrinologist to initiate insulin therapy (p=0.001), (p=0.008) respectively. They believe that patient would not comply with therapy was most frequent barrier for doctors to initiate insulin therapy regardless of job title or workshop/conference attendance (p=0.343), (p=760) respectively. From doctor perspective; patient’s barriers to insulin therapy was fear of needles and injections, hypoglycemia, and that initiation of insulin indicates the progression of the disease (p=0.012). Conclusion: The doctors genuinely had a mixed attitude regarding initiating insulin therapy. Common barriers included the belief that patients would not agree to take insulin because they fear injections, hypoglycemia, and the fact that it will be a long-life treatment.
Salah NA, Abdelaziz SI. Barriers to Insulin Therapy among Family Medicine Doctors in Family Health Care Centers, Sudan. Int J Fam Med Prim Care. 2021; 2(5): 1053.