Barriers to insulin treatment among Australian Torres Strait Islanders with poorly controlled diabetes

Taylor, Sean, Thompson, Fintan, and McDermott, Robyn (2016) Barriers to insulin treatment among Australian Torres Strait Islanders with poorly controlled diabetes. Australian Journal of Rural Health, 24 (6). pp. 363-370.

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Objective: To explore self reported knowledge and attitudes to insulin treatment among a group of adults with poorly controlled diabetes in the Torres Strait islands.

Design:Cross-sectional survey in 2014, interviews with 29 adults with HbA1c ≥ 8.5% (69 mmol mol⁻¹) and not taking insulin, using Insulin Treatment Appraisal Scale (ITAS) and Barriers to Insulin Treatment Questionnaire (BITQ) scores.

Setting: Five remote Torres Strait Island communities in the Torres Strait region.

Participants: Poorly controlled insulin-naïve type 2 diabetics.

Main outcome measures: BITQ and ITAS scores on items related to knowledge and attitudes to insulin treatment, clinical and demographic measures.

Results: Overall, 34% of the cohort had poor glycaemic control. Compared to those with HbA1c ≥ 8.5% and taking insulin (n = 37), the 29 insulin-naïve participants were more obese, more likely to smoke and drink alcohol, have lower mean HbA1c and fewer years with diabetes. Among the insulin-naïve group, those reporting higher 'barriers' (BITQ scores) were older and with lower formal education than those reporting fewer barriers. Torres participants consistently scored low on 'knowledge' items in the ITAS, especially those which would guide insulin initiation (insulin improves glucose control and prevents complications).

Conclusion: Compared to other published studies, the Torres participants had higher scores for BITQ 'barrier' items and lower 'knowledge' scores. This suggests better education around glycaemic control with medication and discussion of perceptions and exchange of experiences with peers who are taking insulin might improve the uptake of insulin in this high-risk group.

Item ID: 45852
Item Type: Article (Research - C1)
ISSN: 1440-1584
Keywords: psychological insulin resistance; Torres Strait Islander; type 2 diabetes
Copyright Information: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Funders: Australian Primary Health Care Research Institute (APHCRI), Commonwealth of Australia (CA), Australian Government Department of Health (AGDH), Torres and Cape Hospital and Health Service (TCHHS), National Heart Foundation (NHF)
Date Deposited: 26 Sep 2016 05:27
FoR Codes: 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450412 Aboriginal and Torres Strait Islander men’s health and wellbeing @ 50%
42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified @ 25%
42 HEALTH SCIENCES > 4203 Health services and systems > 420319 Primary health care @ 25%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 50%
92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 25%
92 HEALTH > 9203 Indigenous Health > 920399 Indigenous Health not elsewhere classified @ 25%
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