Knowledge of insulin use and its determinants among Nigerian insulin requiring diabetes patients

Intensive insulin therapy is essential in the maintenance of strict glycemic control among insulin requiring patients with diabetes. However this presents a challenge in the face of the complexities associated with insulin use and also taking into consideration the potential dangers associated with inappropriate use. Insufficient knowledge of insulin use can result in preventable complications, adverse patient outcome, poor adherence to therapy and invariably poor glycemic control.

Insulin requiring diabetes patients (n = 54) attending the 2012 world diabetes day celebration in a Nigerian community were surveyed using a two part questionnaire. Section A elicited information on their demographics characteristics and participation in update courses, and exercise, while section B assessed knowledge of insulin use using the Michigan Diabetes Research and Training Centre's Brief Diabetes Knowledge Test. All participants who had a good grasp of English language or who could understand the contents of the questionnaire when it was explained to them, and were willing to participate in the study were assessed. Descriptive statistics of percentages was computed for the sociodemographic variables, previous education, satisfaction with education, involvement in regular exercise, knowledge of benefit of exercise and correct response to each question in section B. Analysis of variance (ANOVA) and independent t-test was used to determine the influence of sociodemographic variables on insulin use knowledge.

Knowledge of insulin use is poor among insulin requiring patients with diabetes, with majority not conversant with such terms as ketoacidosis, insulin reaction and low blood sugar. Furthermore, they did not know how to modify their insulin dosage in relation to diet, exercise and infections (e.g. flu). Better knowledge of insulin use was associated with age, employment status, level of education attained, how frequent one reads/attends update courses and satisfaction with education received.

Poor knowledge of the causes and prevention of the ketoacidosis, insulin reaction and hypoglycemia increases their risk of developing them, which will invariably lead to poor adherence to insulin therapy. Therefore this study suggests a methodical, continuous and up-to-date tutelage if proper self management in terms of good glycemic control is to be achieved.