Prevalence of Psychological Insulin Resistance among Adults with Type 2 Diabetes Mellitus at PCEA Chogoria Hospital

Abstract

The aim of this study was to estimate the prevalence of psychological insulin resistance (PIR) among patients with Type 2 Diabetes Mellitus (T2DM) aged 18–80 years attending PCEA Chogoria Hospital, Kenya. Psychological insulin resistance represents a major challenge in the effective management of T2DM, as it often delays or prevents patients from initiating and sustaining insulin therapy. This descriptive cross-sectional study employed consecutive sampling to recruit 121 patients with T2DM attending the outpatient clinic. Data were collected using validated instruments, including the Insulin Treatment Appraisal Scale (ITAS) to assess PIR, the Generalised Anxiety Disorder-7 (GAD-7) for anxiety screening, and the Patient Health Questionnaire-9 (PHQ-9) for depression assessment. Data analysis involved chi-square tests and Fisher’s exact tests to examine associations between variables. PIR was identified in (62.8%) of participants, primarily attributed to feelings of personal failure regarding disease progression reported by (77%) and fear of injections reported by (58%), indicating significant emotional and practical barriers to insulin acceptance. The RE highlight the critical role of psychological factors, particularly self-blame and needle anxiety, in insulin resistance. Integrating mental health support and tailored educational interventions into diabetes management programs may reduce PIR, improve insulin uptake, and enhance overall treatment outcomes for individuals with T2DM in rural Kenya.