Psychological insulin resistance among low-income, U.S. racial minority patients with type 2 diabetes

Publication date:



April 2013


SOURCE:Primary Care Diabetes, Volume 7, Issue 1

Author(s): Suman Machinani , Shahrzad Bazargan-Hejazi , Stanley H. Hsia

AimsTo examine psychological insulin resistance (PIR), the unwillingness to accept insulin therapy, within a unique U.S. population of patients with diabetes.MethodsA cross-sectional survey of PIR among low-income, U.S. Latino and African-American (AA) patients with type 2 diabetes recruited from a diabetes specialty clinic.ResultsData from 136 insulin-na ve respondents (57% female, 69% Latino, mean age 51.1 10.3 years; $200-$1000 median monthly household income; grade 8-12 median education) revealed a 48% prevalence of complete unwillingness to begin insulin. In comparing Latinos to AA, Latino respondents were younger, lived fewer years in the U.S., had less education, were more likely unwilling to use insulin (53% vs. 30%, p=0.03), and reported a more negative attitude to 8 of 9 PIR domains (p 0.01 for each). Fewer years in the U.S. predicted greater unwillingness and a more negative attitude on 8 of 9 PIR domains (p 0.03 for each); and less education predicted greater feelings of unfairness (p=0.01).ConclusionsPIR is highly prevalent among low income, U.S. Latino patients with type 2 diabetes. Our data may help to better guide culturally appropriate counseling regarding insulin use.
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