Factors related to the self-application of insulin in subjects with diabetes mellitus

Moreira, Tiago Ricardo; Toledo, Luana Vieira; Colodette, Renata Maria; Mendonça, Érica Toledo de; Amaro, Marilane de Oliveira Fani; Ayres, Lilian Fernandes Arial; Henriques, Bruno David

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Revista Gaúcha de Enfermagem

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Original Article • Rev. Gaúcha Enferm. 39 • 2018 • https://doi.org/10.1590/1983-1447.2018.2017-0066 copy

Factors related to the self-application of insulin in subjects with diabetes mellitus

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To identify the factors associated with the self-application of insulin in adult individuals with Diabetes Mellitus.

Method:

A cross-sectional study developed in the city of Viçosa-MG, which assessed 142 patients. The data collection was performed between April and July 2013 through an interview at the participant's home. Multiple logistic regression was used.

Results:

The prevalence of the self-administration of insulin was of 67.6%, and it was associated with ages between 57 and 68 years old (OR = 0.3, 95% CI: 0.1-0.9), living with a partner and children (OR = 2.5, 95% CI: 1.1-5.0), 9 years or more of study (OR = 8.4, 95% CI: 1.9-37.9), living in an area not covered by the Family Health Strategy (FHS) (OR = 2.8, 95% CI: 1.1 - 7.0).

Conclusion:

The self-application of insulin was associated with age, schooling, marital status, and the FHS coverage. The recognition of these factors may contribute to the adherence to the self-application of insulin.

Keywords:
Diabetes mellitus; Insulin; Self care; Medication adherence

Variables	n(%)
Gender
Female	78(54.93)
Male	64(45.07)
Age Range
18-56	47(33.10)
57-68	47(33.10)
69-89	48(33.80)
Color/Race
White	78(54.93)
Black	32(22.54)
Mixed race	32(22.54)
Marital Status
Living with a partner and children	90(63.38)
Living with other relatives	52(36.62)
Years of schooling
Illiterate	19(13.38)
1-8	80(56.34)
9 or +	43(30.28)
Type of diabetes
Type 1	32(22.54)
Type 2	77(54.23)
Does not know	33(23.24)
Time of diabetes in years
0-10	49(34.51)
11-20	47(33.10)
21 or +	46(32.39)
Time of insulin in years
0-4	47(33.10)
5-12	49(34.51)
13 or +	46(32.39)
Hypertension
Yes	95(6.90)
No	47(33.10)
Self-application of insulin
Yes	96(67.61)
No	46(32.39)
Medical hospitalization in the last 12 months
Yes	15(10.56)
No	127(89.44)
Living in area covered by the FHS
Yes	95(66.90)
No	47(33.10)
Kind of Service used for the treatment of Diabetes
ESF	26(18.31)
CEAE	96(67.61)
Private doctor	20(14.08)
Received guidance on insulin preparation and application technique
Yes	107(75.35)
No	35(24.65)

Variables	Self-Application of Insulin		p-value^* * Chi-squared test
	No n(%)	Yes n(%)	p-value^* * Chi-squared test
Gender
Female	29(37.18)	49(62.82)	0.178
Male	17(26.56)	47(73.44)
Age Range
18-56	6(12.77)	41(87.23)
57-68	19(40.43)	28(59.57)	0.002
69-89	21(43.75)	27(56.25)
Color/Race
White	18(23.08)	60(76.92)
Black	15(46.88)	17(53.13)	0.028
Mixed race	13(40.63)	19(59.38)
Marital Status
Living with a partner and children	24(26.67)	66(73.33)	0.055
Living with other relatives	22(42.31)	30(57.69)
Years of schooling
Illiterate	12(63.16)	7(36.4)
1-8	29(36.25)	51(63.75)	0.0002
9 or +	5(11.63)	38(88.37)
Type of diabetes
Type 1	6(18.75)	26(81.25)
Type 2	27(35.06)	50(64.94)	0.156
Does not know	13(39.39)	20(60.61)
Time of diabetes in years
0-10	19(38.78)	30(61.22)
11-20	12(25.53)	35(74.47)	0.382
21 or +	15(32.61)	31(67.39)
Time of insulin in years
0-4	19(40.43)	28(59.57)
5-12	14(28.57)	35(71.43)	0.355
13 or +	13(28.26)	33(71.74)
Hypertension
Yes	36(37.89)	59(62.11)	0.046
No	10(21.28)	37(78.72)
Medical hospitalization in the last 12 months
Yes	8(53.33)	7(46.67)	0.082^ Fischer‘s Exact test
No	38(29.92)	89(70.08)
Living in area covered by the FHS
Yes	37(38.95)	58(61.05)	0.017
No	9(19.15)	38(80.85)
Kind of Service used for the treatment of DM
FHS	12(46.15)	14(53.85)
CEAE	29(30.21)	67(69.79)	0.228
Private Doctor	5(25.00)	15(75.00)
Received guidance on insulin preparation and application technique
Yes	33(30.84)	74(69.16)	0.489
No	13(37.14)	22(62.86)

Variables	Model 1		Model 2		Model 3		Model 4		Model 5		Model 6
Variables	OR	IC 95%	OR	IC 95%	OR	IC 95%	OR	IC 95%	OR	IC 95%	OR	IC 95%
Gender
Female	1		1		1
Male	1	0.7-4.4	1.8	0.7-4.5	1.7	0.7-4.4
Age Range
18-56	1		1		1		1		1		1
57-68	0.3	0.1-1.1	0.3	0.1-1.0	0.3	0.1-0.9	0.3	0.1-0.9	0.3	0.1-0.9	0.3	0.1-0.9
69-89	0.4	0.1-1.3	0.3	0.1-1.2	0.3	0.1-1.2	0.3	0.1-1.2	0.4	0.1-1.3	0.4	0.1-1.3
Color/Race
White	1		1		1		1
Black	0.4	0.1-1.2	0.4	0.2-1.2	0.4	0.2-1.2	0.5	0.2-1.3
Mixed race	0.4	0.1-1.2	0.4	0.1-1.2	0.4	0.1-1.1	0.5	0.2-1.3
Marital Status
Living with a partner and children	2.0	0.8-5.0	2.0	0.8-5.0	2.0	0.8-5.0	2.5	1.0-5.0	2.5	0.9-5.0	2.5	1.1-5.0
Living with other relatives	1		1		1		1		1		1
Years of schooling
Illiterate	1		1		1		1		1		1
1-8	2.2	0.7-7.2	2.2	0.7-7.1	2.3	0.7-7.2	2.5	0.8-8.0	2.5	0.8-7.6	2.3	0.7-6.9
9 ou +	5.3	1.1-27.5	5.4	1.1-28.3	6.6	1.3-32.8	7.8	1.6-38.3	9.2	2.0-42.7	8.4	1.9-37.9
Type of diabetes
Type 1	1		1
Type 2	0.59	0.2-2.2	0.6	0.2-2.1
Does not know	0.50	0.1-2.1	0.5	0.1-2.1
Hypertension
Yes	1
No	1.30	0.5-3.7
Medical Hospitalization in the last 12 months
Yes	1		1		1		1		1
No	3.89	0.9-15.3	3.8	0.9-14.7	3.2	0.9-11.4	2.9	0.8-10.3	2.9	0.8-10.3
Living in area covered by the FHS
Yes	1		1		1		1		1		1
No	2.87	1.1-7.8	2.94	1.1-8.0	2.9	1.1-7.9	2.78	1.1-7.4	2.86	1.1-7.5	2.8	1.1-7.0

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[1] Corresponding author:
Tiago Ricardo Moreira. tiago.ricardo@ufv.br