Department of Family Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon.
Fam Pract. 2013 Oct;30(5):560-7. doi: 10.1093/fampra/cmt022. Epub 2013 Jun 1.
Studies assessing attitudes and beliefs of physicians regarding insulin therapy in Arab countries are scant despite the high prevalence of type 2 diabetes mellitus (T2DM).
This study examines family physicians' attitudes and beliefs towards insulin therapy in T2DM patients in the East Mediterranean Region of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians.
This is a cross-sectional study conducted on 348 family physicians invited via email to fill an anonymous online questionnaire about their attitudes, beliefs and perceived barriers regarding insulin initiation in T2DM patients.
One hundred and twenty-two physicians completed the questionnaire. Of the 122 physicians, 73.6% preferred to delay insulin initiation until it is absolutely essential and 59.0% initiated it themselves. The majority agreed that T2DM patients benefit from insulin prior to the development of complications (85.7%) and that patient education is important (99.1%) and uncomplicated (74.7%). Sixty-three per cent expressed reluctance to start insulin mostly because of perceived patients' reluctance. Referral to endocrinologists to initiate insulin therapy was associated with inadequate experience and concern about risks, particularly in elderly patients (backward logistic regression, P < 0.05). Physicians' reluctance to initiate insulin therapy was associated with patients' perception of insulin initiation as a personal failure and threat to the quality of life (backward logistic regression, P < 0.05).
Although family physicians in the Arab world believe in the benefits of insulin therapy, many are reluctant to initiate it themselves. Further studies are needed per country, as well as multiple measures to minimize the physicians' barriers to insulin prescription.
尽管 2 型糖尿病（T2DM）的患病率很高，但评估阿拉伯国家医生对胰岛素治疗的态度和信念的研究却很少。
本研究旨在调查世界家庭医生组织/家庭医生区域学院联合会东地中海地区的家庭医生对 T2DM 患者胰岛素治疗的态度和信念。
这是一项横断面研究，通过电子邮件邀请 348 名家庭医生填写一份匿名在线问卷，了解他们对 T2DM 患者起始胰岛素治疗的态度、信念和感知障碍。
122 名医生完成了问卷。在 122 名医生中，73.6%的医生倾向于等到绝对必要时才开始胰岛素治疗，59.0%的医生自己开始胰岛素治疗。大多数医生认为 T2DM 患者在出现并发症之前受益于胰岛素（85.7%），并且认为患者教育很重要（99.1%）且无并发症（74.7%）。63%的医生表示不愿意开始胰岛素治疗，主要是因为他们认为患者不愿意接受。将胰岛素治疗转介给内分泌科医生与经验不足和对风险的担忧有关，尤其是在老年患者中（向后逻辑回归，P<0.05）。医生不愿意开始胰岛素治疗与患者将胰岛素起始视为个人失败和对生活质量的威胁有关（向后逻辑回归，P<0.05）。
尽管阿拉伯世界的家庭医生相信胰岛素治疗的益处，但许多医生不愿自己开始胰岛素治疗。需要针对每个国家进行进一步的研究，并采取多种措施来最小化医生对胰岛素处方的障碍。
