Initiating insulin as part of the Treating to Target in Type 2 Diabetes (4-T) trial: A interview study of patients' and health professionals' experiences
- Dr. Nicholas Jenkins, PhD. (n.e.jenkins{at}ed.ac.uk)(1),
- Dr. Nina Hallowell, D.Phil(2),
- Professor Andrew J Farmer, M.A., D.M., B.M., B.Ch., F.R.C.G.P.(3),
- Professor Rury R Holman, M.B., Ch.B., F.R.C.P(4) and
- Dr. Julia Lawton, Ph.D.(5)
- 1) Centre for Population Health Sciences, University of Edinburgh
- 2) Institute of Health and Society, Newcastle University
- 3) Department of Primary Health Care, University of Oxford
- 4) Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford
- 5) Centre for Population Health Sciences, University of Edinburgh
Abstract
Objective: To explore patients' and health professionals' experiences of initiating insulin as part of the Treating to Target in Type 2 Diabetes (4-T) randomized controlled trial.
Research Design & Methods: Interviews were conducted with 45 trial participants and 21 health professionals and analyzed thematically.
Results: Patients were generally ‘psychologically insulin receptive’ when approached to participate in 4-T. Receptiveness arose largely from personal experiences of observing prior treatments intensify and blood glucose control deteriorate over time, which led patients to engage with and accept the idea that their diabetes was progressive. Health professionals also fostered receptiveness by drawing on their clinical experience to manage patients' anxieties about initiating insulin.
Conclusions: Previous studies may have over emphasized the problem of psychological insulin resistance, and overlooked factors and treatment experiences which may promote insulin receptiveness amongst type 2 patients.
Footnotes
- Received March 15, 2010.
- Accepted June 23, 2010.
- Copyright © American Diabetes Association
