Jasper Unyime Sunday, Opara Macmillian Chinonso, Pyiki Edna Bawa, Akinrolie Olayinka
Department of Physiotherapy, Jos University Teaching Hospital, Jos, Nigeria.
J Diabetes Metab Disord. 2014 Jan 7;13(1):10. doi: 10.1186/2251-6581-13-10.
Intensive insulin therapy is essential in the maintenance of strict glycemic control among insulin requiring patients with diabetes. However this presents a challenge in the face of the complexities associated with insulin use and also taking into consideration the potential dangers associated with inappropriate use. Insufficient knowledge of insulin use can result in preventable complications, adverse patient outcome, poor adherence to therapy and invariably poor glycemic control.
Insulin requiring diabetes patients (n = 54) attending the 2012 world diabetes day celebration in a Nigerian community were surveyed using a two part questionnaire. Section A elicited information on their demographics characteristics and participation in update courses, and exercise, while section B assessed knowledge of insulin use using the Michigan Diabetes Research and Training Centre's Brief Diabetes Knowledge Test. All participants who had a good grasp of English language or who could understand the contents of the questionnaire when it was explained to them, and were willing to participate in the study were assessed. Descriptive statistics of percentages was computed for the sociodemographic variables, previous education, satisfaction with education, involvement in regular exercise, knowledge of benefit of exercise and correct response to each question in section B. Analysis of variance (ANOVA) and independent t-test was used to determine the influence of sociodemographic variables on insulin use knowledge.
Knowledge of insulin use is poor among insulin requiring patients with diabetes, with majority not conversant with such terms as ketoacidosis, insulin reaction and low blood sugar. Furthermore, they did not know how to modify their insulin dosage in relation to diet, exercise and infections (e.g. flu). Better knowledge of insulin use was associated with age, employment status, level of education attained, how frequent one reads/attends update courses and satisfaction with education received.
Poor knowledge of the causes and prevention of the ketoacidosis, insulin reaction and hypoglycemia increases their risk of developing them, which will invariably lead to poor adherence to insulin therapy. Therefore this study suggests a methodical, continuous and up-to-date tutelage if proper self management in terms of good glycemic control is to be achieved.
强化胰岛素治疗对于需要胰岛素治疗的糖尿病患者维持严格的血糖控制至关重要。然而，鉴于胰岛素使用的复杂性以及考虑到不当使用可能带来的潜在危险，这带来了一项挑战。对胰岛素使用知识的不足可能导致可预防的并发症、不良的患者结局、对治疗的依从性差以及血糖控制不佳。
在尼日利亚一个社区参加2012年世界糖尿病日庆祝活动的需要胰岛素治疗的糖尿病患者（n = 54）使用两部分问卷进行了调查。A部分获取了他们的人口统计学特征以及参加更新课程和锻炼的信息，而B部分使用密歇根糖尿病研究与培训中心的简短糖尿病知识测试评估胰岛素使用知识。所有能很好掌握英语或在向他们解释问卷内容时能理解问卷内容且愿意参与研究的参与者都进行了评估。计算了社会人口统计学变量、既往教育情况、对教育的满意度、参与定期锻炼情况、对锻炼益处的了解以及B部分每个问题的正确回答的百分比描述性统计数据。使用方差分析（ANOVA）和独立t检验来确定社会人口统计学变量对胰岛素使用知识的影响。
需要胰岛素治疗的糖尿病患者对胰岛素使用的知识较差，大多数人不熟悉酮症酸中毒、胰岛素反应和低血糖等术语。此外，他们不知道如何根据饮食、运动和感染（如流感）来调整胰岛素剂量。对胰岛素使用有更好的了解与年龄、就业状况、所达到的教育水平、阅读/参加更新课程的频率以及对所接受教育的满意度有关。
对酮症酸中毒、胰岛素反应和低血糖的病因及预防知识了解不足会增加其发生的风险，这必然会导致对胰岛素治疗的依从性差。因此，本研究表明，如果要在良好的血糖控制方面实现适当的自我管理，就需要有条理、持续且最新的指导。
