Psychological Insulin Resistance and its Association with Glycemic Control among Patients with Diabetes Mellitus: A Cross-Sectional Study

Background: Psychological insulin resistance (PIR) is a significant barrier to optimal glycemic control in patients with diabetes mellitus.PIR stems from misconceptions, fear of side effects, and social stigma, leading to reluctance in initiating or adhering to insulin therapy.This study assesses PIR among diabetic patients on insulin therapy and evaluates its correlation with glycemic control using the Insulin Treatment Appraisal Scale (ITAS).Methods: A hospital-based cross-sectional study was conducted in the Department of General Medicine at PGIMER and Capital Hospital, Bhubaneswar.A total of 386 patients with Type 1 or Type 2 diabetes mellitus, on insulin therapy for more than six months, were included.The ITAS questionnaire was administered to evaluate patients' perceptions of insulin therapy.Glycemic control was assessed using HbA1c levels.Data analysis was performed using SPSS version 22, and Spearman correlation was used to assess the relationship between ITAS scores and HbA1c levels. Results:The study population had a mean age of 53.79.9 years, with 62.4% males.The majority (49%) had been on insulin for 2-5 years.PIR was evident in a substantial proportion of participants, with concerns regarding insulin-related stigma, lifestyle adjustments, fear of hypoglycemia, and weight gain.Correlation analysis revealed a statistically significant relationship between negative perceptions of insulin therapy and poor glycemic control (HbA1c >9.0%, p<0.05).Conclusion: Psychological barriers have a significant impact on insulin adherence and glycemic outcomes.Addressing misconceptions through patient education and counseling is crucial for improving insulin acceptance and optimizing diabetes management.