Thasala Hospital, Thasala, Nakhon Si Thammarat, Thailand.
School of Medicine, Walailak University, Thasala, Nakhon Si Thammarat, Thailand.
Rom J Intern Med. 2021 May 8;59(2):151-158. doi: 10.2478/rjim-2020-0040. Print 2021 Jun 1.
Insulin injection refusal is a challenge when initiating insulin therapy. This study aimed to investigate the effects of an actual insulin injection demonstration on insulin acceptance in patients with type 2 diabetes mellitus (T2DM). A pragmatic randomised controlled trial (RCT) was conducted. The participants were patients with T2DM aged 18-65 years old. The control group (CG) received an educational programme regarding T2DM. The intervention group (IG) received the educational programme and actual insulin injection demonstration (a physician-led sample insulin injection using an insulin pen). The main outcome was immediate insulin acceptance. Insulin adherence, glycated haemoglobin (HbA1c), and adverse effects of insulin were evaluated at three months after the intervention. Forty-nine participants with T2DM were allocated to the IG (n = 24) and the CG (n = 25). The immediate insulin acceptance was significantly higher in the IG (79.17%, n = 19) than the CG (24.00%, n = 6; p < 0.05; RR 3.30, 95% CI 1.59 to 6.82). At the three-month follow-up, the insulin adherence was significantly different between the two groups (IG: 75.00%, n = 18 vs CG: 20.00%, n = 5; p < 0.05; RR 3.75, 95% CI 1.66 to 8.49). Adverse effects of insulin, HbA1c levels, and changes in HbA1c levels between the IG and CG were not different. The physician-led actual insulin injection demonstration is effective for increasing insulin acceptance among participants with T2DM.
胰岛素注射拒绝是起始胰岛素治疗时面临的挑战。本研究旨在探讨实际胰岛素注射演示对 2 型糖尿病（T2DM）患者接受胰岛素治疗的影响。进行了一项实用随机对照试验（RCT）。参与者为年龄在 18-65 岁的 T2DM 患者。对照组（CG）接受了关于 T2DM 的教育计划。干预组（IG）接受了教育计划和实际胰岛素注射演示（医生主导的使用胰岛素笔的样本胰岛素注射）。主要结局是立即接受胰岛素。在干预后三个月评估胰岛素依从性、糖化血红蛋白（HbA1c）和胰岛素的不良反应。49 名 T2DM 患者被分配到 IG（n = 24）和 CG（n = 25）。IG（79.17%，n = 19）的即时胰岛素接受率明显高于 CG（24.00%，n = 6；p < 0.05；RR 3.30，95%CI 1.59 至 6.82）。在三个月的随访中，两组之间的胰岛素依从性有显著差异（IG：75.00%，n = 18 与 CG：20.00%，n = 5；p < 0.05；RR 3.75，95%CI 1.66 至 8.49）。胰岛素的不良反应、HbA1c 水平以及 IG 和 CG 之间 HbA1c 水平的变化没有差异。医生主导的实际胰岛素注射演示对增加 T2DM 患者对胰岛素的接受度有效。
