Factors influencing psychological insulin resistance in type 2 diabetes patients.

Aims: This descriptive, exploratory, correlational analysis investigated patients with type 2 diabetes and their diabetes knowledge, depression, diabetes‐management self‐efficacy, and social support and sought to determine the effects of these factors on psychological insulin resistance among type 2 diabetes patients in South Korea. Methods: This descriptive cross‐sectional study included 136 patients with type 2 diabetes who visited an endocrinology clinic. A structured questionnaire and electronic medical records were used to collect data regarding demographic and disease‐related characteristics as well as scores on the Diabetes Knowledge Tests, Center for Epidemiologic Studies Depression Scale, Diabetes Management Self‐efficacy Scale, Social Support Scale, and Psychological Insulin Resistance Scale, between September and December 2017. Data were analysed using descriptive statistics, independent t‐tests, a one‐way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression. Results: The total score for psychological insulin resistance was 60.92 ± 14.75 of a maximum of 90. Stepwise multiple regression showed that diabetes knowledge, diabetes‐management self‐efficacy, social support, absence of diabetes complications, and depression explained 38.6% of the variance in psychological insulin resistance. Conclusion: Diabetes knowledge was found to have the largest influence on psychological insulin resistance, followed by social support, absence of complications, depression, and diabetes‐management self‐efficacy. Development of interventions that consider all these factors is required, and the effects of such interventions should be tested through further research. SUMMARY STATEMENT: What is already known about this topic? Patients with diabetes in Korea have been reported to have relatively high levels of psychological resistance to insulin therapy compared with their counterparts in the West.Previous studies on factors associated with psychological insulin resistance have considered only a limited number of factors and have simply analysed the association between these factors. The full range of disease‐related factors that can affect psychological insulin resistance has not been considered.Research on the psychological insulin resistance of patients with type 2 diabetes, and the factors that affect it, is currently lacking in Korea. What this paper adds? The level of psychological insulin resistance of Korean patients with type 2 diabetes was found to be higher than that of patients from other countries.Diabetes knowledge was found to have the most significant influence on the psychological insulin resistance in Korean patients with type 2 diabetes, followed by social support, absence of diabetes complications, depression, and diabetes‐management self‐efficacy. The implications of this paper: Levels of psychological insulin resistance among patients with type 2 diabetes should be monitored, and nursing education programs should be developed that are tailored to patients' level of psychological insulin resistance.Diabetes knowledge, social support, diabetes complications, depression, and diabetes‐management self‐efficacy should be systematically monitored to reduce the level of psychological insulin resistance in patients with type 2 diabetes. Development of detailed interventions that consider these factors may be helpful, and their effectiveness should be tested through further research. [ABSTRACT FROM AUTHOR]