Original Research

Prevalence and determinants of psychological insulin resistance among type 2 diabetic patients in Kinshasa, Democratic Republic of Congo

Shomba L. Rita, Fina J.-P. Lubaki, Lepira F. Bompeka, Gboyega A. Ogunbanjo, Lukanu P. Ngwala
African Journal of Primary Health Care & Family Medicine | Vol 11, No 1 | a1993 | DOI: https://doi.org/10.4102/phcfm.v11i1.1993 | © 2019 Shomba L. Rita, Fina J.-P. Lubaki, Lepira F. Bompeka, Ogunbanjo A. Gboyega, Lukanu P. Ngwala | This work is licensed under CC Attribution 4.0
Submitted: 17 November 2018 | Published: 22 July 2019

About the author(s)

Shomba L. Rita, Centre Hospitalier Mère-Enfant Monkole, Kinshasa, The Democratic Republic of the Congo; and, Department of Family Medicine and Primary Health Care, Protestant University of Congo, Kinshasa, Congo, the Democratic Republic of the
Fina J.-P. Lubaki, Department of Family Medicine and Primary Health Care, Protestant University of Congo, Kinshasa, Congo, the Democratic Republic of the
Lepira F. Bompeka, Service de Néphrologie, Cliniques Universitaires de Kinshasa, Kinshasa, Congo, the Democratic Republic of the
Gboyega A. Ogunbanjo, Department of Family Medicine, Sefako Makgato University, Pretoria, South Africa
Lukanu P. Ngwala, Department of Family Medicine and Primary Health Care, Protestant University of Congo, Kinshasa, Congo, the Democratic Republic of the


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Abstract

Background: Psychological insulin resistance (PIR) is a common but unappreciated phenomenon by health care providers with a negative impact on the control of type 2 diabetes mellitus.

Aim: To determine the frequency of PIR and its determinants in patients with type 2 diabetes.

Setting: This study was conducted in Kinshasa in three health centres providing management of diabetic patients.

Methods: This study was a multicentric, cross-sectional study conducted from 01 November 2017 to 31 March 2018 in Kinshasa among 213 type 2 diabetic patients who were taking oral anti-diabetic drugs. A standardised questionnaire, the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ), was used for data collection.

Results: The average age of participants was 59.8 ± 11.1 years with a male to female ratio of 1.5. The prevalence of PIR was 42.7%; and its main determinants were 50 years of age (odds ratios [OR] adjusted 2.05; 95% confidence interval [CI] 1.98–4.27; p = 0.045), the presence of complications (OR adjusted 3.33; 95% CI 1.68–6.60; p = 0.001), lack of knowledge about insulin therapy (OR adjusted 1.96; 95% CI 1.03–3.71; p = 0.040) and the high cost of insulin (OR adjusted 2.32; 95% CI 1.08–4.95; p = 0.030).

Conclusion: The study showed that almost half of type 2 diabetic patients had PIR with the main determinant factors related to the patient and the health system. The establishment of a therapeutic education programme, improved ‘provider–patient’ communication and the development of approaches to increase access to drugs are crucial to reduce the prevalence of PIR.


Keywords

psychological insulin resistance, therapy; type 2 diabetes mellitus; frequency; determinants

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