A study of adults with type 1 diabetes : investigating insulin omission

• Main Author: Ames, Sophie
• Published: University of East Anglia 2017
• Subjects: 610
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738654

Many people with diabetes find it difficult to adhere to their insulin medication regime, and may omit or restrict their insulin doses. Insulin omission has been linked to poorer health outcomes. The reasons behind insulin omission however, are not well understood. The current research was designed to explore insulin omission in adults with type 1 diabetes. The research aims included: 1) To critically evaluate the way that adherence to insulin medication had been measured in previous studies. 2) To develop an appropriate measure of insulin omission for use in this study. 3) To investigate the relationships between insulin omission, general self-efficacy, diabetes specific self-efficacy, depression, and diabetes self-management. 4) To investigate reasons for insulin omission. A systematic review of measures used to assess insulin adherence for people with type 1 diabetes was conducted. This demonstrated that existing measurement of insulin adherence was inconsistent, measures were not validated for type 1 diabetes, and did not allow scope for understanding reasons for insulin non-adherence or omission. The empirical study included the development of a measure of insulin omission as well as an online survey (n=231) assessing factors associated with, and reasons for, insulin omission. Results of this study showed that insulin omission was associated with low self-efficacy, high depression scores, and poor overall diabetes self-management (all p < .001). The narrative information about reasons for insulin omission collected in the questionnaire generated themes on: a) Prioritising: Forgetting and the demands of daily lifestyle, b) Diabetes-related emotional distress, c) Weight control, d) Avoidance: Fear of physical effects, and e) Adaptive responses to managing blood sugar levels. Theoretical and clinical implications are identified and recommendations for further research are discussed.