Markers affecting the continuity of insulin therapy in tip 2 diabetes mellitus patients whom recently started using insülin

Introduction: Type 2 Diabetes Mellitus (DM) is a disease which can be seen with complications and causes mortality and morbidity with increasing frequency worldwide. Oral antidiabetic agents (OAD) and insülin are used in Type2 diabetes treatment. In diagnosis and follow-up of Type 2 diabetics, blood glucose monitoring and hemoglobin A1c (HbA1c = A1c) levels are used and insulin need is determined accordingly. Significant number of patients (%39) is unwilling to use insulin and the most common causes shown in studies are getting used to insulin use, fear of insulin, not recognizing the numbers and hearing unfavorable things from environment about insulin. We have designed to determine our work in patients who started insulin use, our HbA1c targets, FPG, BMI averages, release insulin, interruption of insulin, skip a dose of insulin use and difficulty survival rates and causes, hypoglycemia rates and inter-group differences. Materials and Methods: 125 patients were enrolled in our study that just started insülin use. Patients were divided into 3 groups according to their insulin group; group 1 basal insulin, group 2 mix insulin, Group 3 basal bolus insulin. The demographic characteristics of the patients, comorbidities, treatments, and glycemic control and laboratory parameters were recorded. Patients completed a questionnaire with 10 questions. We were asked questions to determine markers affecting the use of insulin,causes of release insulin, insulin pause, skip the dose of insulin use. All statistical analyzes were performed on SPSS 18 and p <0.05 was considered statistically significant. Results: In our study, no significant difference is found between insülin groups in terms of stopping or pausing insülin use, skipping doses, experiencing difficulties, reaching target HbA1c rates and categorical variables (p>0.05). From 125 patients, 15 patients stopped insulin (%13.2). When insulin release in the first week of the most common 60% dropout rate, the dropout rate between 1-3 months was observed in 26.7%. The most common reason for discontinuation in the first two reasons; I'm scared of needles being used to 53.3%, I do not make insulin because the sugar is normal or low 33.3%. The 0th and 3rd months average exchange weight difference -0.211 kg of basal insulin group, mix insulin group +0.990 kg, +2.460 kg of basal-bolus group (p> 0.05). Insulin dose increased, the number of patients of average weight has increased. Mean change in FPG of basal insulin group -57 mg/dl, in a mixture of insulin group -68 mg/dl, in basal-bolus group -164 mg/dl. Insulin group were similar to the rate of HbA1c is below 7 (p> 0.05). Insulin used the number of doses increased, the rate being the target was low. The rate was 33.3% in the basal insulin group, falling to hinterland rate of basal-bolus group and reached 14.8%. Of patients were found to have difficulty in complying with the insulin. Conclusion: Of patients with the use of insulin have identified challenges particularly associated with the increased number of insulin dose. When starting insulin to the patient, we opinion, be preferred in the first basal insulin therapy for both is less than the number of doses and patients because they indicate that it is easier to use and have higher proportions of patients in the target between insulin groups. Just not the kind of insulin, as an obstacle in the use of insulin in patients with glucose decrease fear and fearful of gaining weight, basal insulin therapy may be preferred to the other insulin group due to have a neutral effect in weight or influence mind less weight gain. Especially for the first time since starting insulin release more insulin ratio, in addition to emotional support for the patient acceptance of insulin, there will be continuous including intensive training is required in patients at that time. Public education and awareness in order to increase awareness of diabetes is also required. Insulin therapy and monitoring, with an appropriate treatment to give the physician to the patient, patient compliance with the therapy and suggest that it is of great importance. If the patients improve adherence to the use of insulin, achieving treatment goals for patients and maintenance it will be more possible.