Type 2 Diabetes Patient Psychological Insulin Resistance Research

OBJECTIVES:We investigated the imformation of the patients who had visited the clinic service and wards of the Zhongshan Hospital by questionnaires to find out the reasons of the psychological insulin resistance of type 2 diabetes patients and analysis the difference in the psychological insulin resistance between the patients who had used insulin or not,so that we can provide theopy evidence for education of insulin therapy for diabetics.METHODS:We collected the imformation of the patients who visited the clinic service and the wards of the Zhongshan Hospital from December in 2007 to March in 2008 by the methods of the investigation questionnaires,including the general state of health,Hemoglobin Alc,diabetic complications,the method of therapy and attitudes towards the insulin and etc.We used SPSS 11.0 as the statistic software while we used the regulative t-test to deal with two groups of continuous data of heterogeneity of variance in a normal distribution population,the Mann-Whitney rank-sum test to deal with two groups of ranked data and the Spearman rank correlation analysis to deal with two groups of continuous skewness measurement data.RESULTS:We have collected the questionnares of 400 patients altogather.301 patients knew his or her recent Hemoglobin Alc:8.71±4.10%,,only18.27%patients had reach the target.Family history,course of disease,hyperlipemia,hyperglycemia,whether to use insulin and blood pressure control have relationship between the diabetic complications.After excluding the confusing factors,we find that there is a significance in statistics that insulin therapy leads to less diabetic complications if the course of disease is shorter than 11 years,while there isn't the significance if the course of disease is 11 years or longer.We also find that there is a significance in statistics that insulin therapy leads to hypoglycemia if the course of disease is shorter than 11 years,while there isn't the significance if the course of disease is 11 years or longer.We analysized the attitudes of the patients towards insulin therapy and found out that patients who hadn't use insulin as therapy show less willing to start insulin therapy than the insulin users in a significant difference in statistics even if they knew that using insulin can bring them better blood glycose control.They are more worrying about the pain of using insulin and they are more likely to regard insulin therapy as a signal of the aggravated disease,the malfunction of the drugs and can never stop using it.They thought insulin therapy would bring them more trouble in life,they felt embarrassing about it and also considered it would increase their expense. CONCLUSION:1,The insulin therapy in the earlier period of the course will lead to better blood control and less complications while the control efficiency is not very good in the advanced stage.2,Almost all the diabetics have psychological insulin resistance.The psychological insulin resistance of the diabetics mainly exists in 1)the problems about insulin injection such as pain,being embarrassing and getting more trouble;2)the problems about aspiration of insulin theray such as medical cost and addiction;3)the problems about side effects of insulin such as hypoglycemia and weight gain.Those who had used insulin turned out to be more tolerant to insulin therapy in the problems about insulin injection and aspiration of insulin.