Factors Affecting Insulin Therapy Acceptance Among Patients with Type 2 Diabetes Mellitus at a Tertiary Care Center in Jordan
DOI:
https://doi.org/10.35516/jmj.v60i2.4991Keywords:
Diabetes Mellitus, Type 2; Insulin; Patient Acceptance of Health Care; Jordan.Abstract
Introduction: Although insulin plays a vital role in managing blood sugar levels, many patients are reluctant or unwilling to start insulin therapy. This hesitation stems from a range of factors—demographic, psychological, social, financial, and clinical. While these barriers have been well-documented internationally, limited research has explored them in the Jordanian context.
Aim: This study will investigate the factors influencing insulin refusal among Jordanian patients with type 2 diabetes mellitus (T2DM). By identifying the main barriers, we hope to support the development of targeted strategies that improve insulin acceptance, patient adherence, and overall diabetes care in Jordan.
Methodology: A cross-sectional study was conducted at Jordan University Hospital, involving 1,010 adult T2DM patients selected through systematic random sampling. Data were collected via structured, face-to-face interviews led by sixth-year medical students using a validated questionnaire adapted from Ghadiri-Anari et al. (2013). Data analysis was performed using SPSS.
Results: Among the participants, 27.4% declined insulin therapy, while 17.4% expressed hesitation. Insulin refusal was significantly associated with gender, age, education, and income, whereas factors like duration of diabetes and family history showed no significant association. The most cited reason for refusal was the belief that starting insulin signified worsening disease (40%), followed by fear of hypoglycemia (34.8%) and weight gain (27.9%). Notably, 72.4% of patients did not consider insulin cost a barrier.
Conclusion: Insulin refusal among Jordanian patients with T2DM is shaped by a multifaceted set of influences. Demographic variables such as age, gender, and education level significantly affect patient attitudes. Psychological concerns—especially fear of injections and hypoglycemia—also play a key role. While cost was less of a concern for most patients, lower income still showed some association with refusal. These findings highlight the need for patient-centered interventions and awareness campaigns that address fears, correct misconceptions, and support informed decision-making. Further longitudinal studies are recommended to explore how these attitudes evolve over time.
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