Beliefs about Insulin Treatment of Type 2 Diabetic Patients in Kinshasa, Democratic Republic of the Congo

Background: It is not rare that diabetic patients, motivated by many beliefs, express resistance at the initiation of insulin therapy leading to delays of treatment and subsequent poor control of diabetes. Knowledge of patients’ beliefs towards insulin is essential to better orient the education of diabetics. Methods: This is a cross-sectional study aimed at identifying beliefs about insulin therapy in our community using a psychometric test, “the Ch-ASIQ (The Chinese Attitudes to Starting Insulin Questionnaire)” among 213 diabetic patients in three diabetes management health facilities in Kinshasa. Logistic regression was performed to determine significant beliefs among participants with psychological insulin resistance. The statistical significance level is p <0.05. Results: Out of 213 patients included in the study, 42.7% had psychological insulin resistance. The psychological insulin resistance was motivated by the worry for patients that other people know they have diabetes through the insulin treatment [ORa: 3,44 (1,15-5,56), p: 0,000], the pain caused by insulin injection [ORa: 4.65 (1.42-7.05), p: 0.003], the worry over the need to perform home blood glucose monitoring (OR: 3.55 (1.35-6.87), p: 0.011) and the lack of family support to support them to inject insulin [ORa: 5.43 (2.92) -10.10), p: 0.000]. Conclusion: There is a need for education of both diabetic patients and their entourage in order to successfully remove barriers to insulin adherence. Alleviating financial burden of patients and families will help to face additional obstacles related to cost.