In this study we aimed to identify the perceptions and thoughts and their association with state/trait anxiety, depression that may lead to resistance to insulin treatment in patients with previously diagnosed type 2 diabetes mellitus (DM) patients in order to facilitate their compliance with insulin treatment.

In this study, 120 patients were recruited with a previous type 2 DM diagnosis from the diabetes outpatient clinic. Patients were evaluated with sociodemographic data, State-Trait Anxiety Inventory, Problem Areas in Diabetes Scale, Insulin Treatment Appraisal Scale, Beck Depression Inventory.

A majority of the patients were found to have resistance for startinginsulin treatment. Most of the patientswho were on other treatment alternatives reported that they wouldn’t use insulin even if they were prescribed insulin. A significant number of patients reported negative perceptions and thoughts about insulin treatment such as “insulin is a punishment”, “it is a shame to use insulin where other people can see”. In women injection phobia was significantly higher. Injection avoidance was significantly high and was more related to feeling insufficient about administration instead of worries about pain. Psychological resistance to insulin was significantly related to depression but not associated with state or trait anxiety levels. Lack of education and knowledge was found to be another important contributor to this resistance.

Type 2 DM patients show psychological resistance to insulin treatment due to negative perceptions and thoughts about the treatment. Cognitive interventions targeting these factors may be useful to overcome psychological insulin resistance and faciliate glisemic control.

The authors have not supplied their declaration of competing interest.