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.