A Practitioner's Toolkit for Insulin Motivation in Adults with Type 1 and Type 2 Diabetes Mellitus: Evidence-Based Recommendations from an International Expert Panel.

Initiation Insulin distress Intensification Motivational interviewing Practitioner’s tool kit Pre-initiation Titration

Journal

Diabetes therapy : research, treatment and education of diabetes and related disorders
ISSN: 1869-6953
Titre abrégé: Diabetes Ther
Pays: United States
ID NLM: 101539025

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 19 11 2019
pubmed: 26 1 2020
medline: 26 1 2020
entrez: 26 1 2020
Statut: ppublish

Résumé

To develop an evidence-based expert group opinion on the role of insulin motivation to overcome insulin distress during different stages of insulin therapy and to propose a practitioner's toolkit for insulin motivation in the management of diabetes mellitus (DM). Insulin distress, an emotional response of the patient to the suggested use of insulin, acts as a major barrier to insulin therapy in the management of DM. Addressing patient-, physician- and drug-related factors is important to overcome insulin distress. Strengthening of communication between physicians and patients with diabetes and enhancing the patients' coping skills are prerequisites to create a sense of comfort with the use of insulin. Insulin motivation is key to achieving targeted goals in diabetes care. A group of endocrinologists came together at an international meeting held in India to develop tool kits that would aid a practitioner in implementing insulin motivation strategies at different stages of the journey through insulin therapy, including pre-initiation, initiation, titration and intensification. During the meeting, emphasis was placed on the challenges and limitations faced by both physicians and patients with diabetes during each stage of the journey through insulinization. After review of evidence and discussions, the expert group provided recommendations on strategies for improved insulin acceptance, empowering behavior change in patients with DM, approaches for motivating patients to initiate and maintain insulin therapy and best practices for insulin motivation at the pre-initiation, initiation, titration and intensification stages of insulin therapy. In the management of DM, bringing in positive behavioral change by motivating the patient to improve treatment adherence helps overcome insulin distress and achieve treatment goals.

Sections du résumé

AIM OBJECTIVE
To develop an evidence-based expert group opinion on the role of insulin motivation to overcome insulin distress during different stages of insulin therapy and to propose a practitioner's toolkit for insulin motivation in the management of diabetes mellitus (DM).
BACKGROUND BACKGROUND
Insulin distress, an emotional response of the patient to the suggested use of insulin, acts as a major barrier to insulin therapy in the management of DM. Addressing patient-, physician- and drug-related factors is important to overcome insulin distress. Strengthening of communication between physicians and patients with diabetes and enhancing the patients' coping skills are prerequisites to create a sense of comfort with the use of insulin. Insulin motivation is key to achieving targeted goals in diabetes care. A group of endocrinologists came together at an international meeting held in India to develop tool kits that would aid a practitioner in implementing insulin motivation strategies at different stages of the journey through insulin therapy, including pre-initiation, initiation, titration and intensification. During the meeting, emphasis was placed on the challenges and limitations faced by both physicians and patients with diabetes during each stage of the journey through insulinization.
REVIEW RESULTS RESULTS
After review of evidence and discussions, the expert group provided recommendations on strategies for improved insulin acceptance, empowering behavior change in patients with DM, approaches for motivating patients to initiate and maintain insulin therapy and best practices for insulin motivation at the pre-initiation, initiation, titration and intensification stages of insulin therapy.
CONCLUSIONS CONCLUSIONS
In the management of DM, bringing in positive behavioral change by motivating the patient to improve treatment adherence helps overcome insulin distress and achieve treatment goals.

Identifiants

pubmed: 31981212
doi: 10.1007/s13300-020-00764-7
pii: 10.1007/s13300-020-00764-7
pmc: PMC7048897
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

585-606

Subventions

Organisme : Sanofi India
ID : -

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Auteurs

Sanjay Kalra (S)

Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India. brideknl@gmail.com.

Sarita Bajaj (S)

Department of Endocrinology, MLN Medical College, Allahabad, Uttar Pradesh, India.

Surendra Kumar Sharma (SK)

Diabetes, Thyroid and Endocrine Centre, Galaxy Specialty Centre, Jaipur, Rajasthan, India.

Gagan Priya (G)

Department of Endocrinology, Fortis Hospital, Chandigarh, Punjab, India.

Manash P Baruah (MP)

Department of Endocrinology, Excel Hospital, Guwahati, Assam, India.

Debmalya Sanyal (D)

Department of Endocrinology, KPC Medical College, Kolkata, West Bengal, India.

Sambit Das (S)

Department of Endocrinology, Apollo Hospitals, Bhubaneswar, India.

Tirthankar Chaudhury (T)

Department of Diabetes and Endocrinology, Apollo Gleneagles Hospital, Kolkata, India.

Kalyan Kumar Gangopadhyay (KK)

Department of Diabetology and Endocrinology, Peerless Hospital and B K Roy Research Centre, Kolkata, West Bengal, India.

Ashok Kumar Das (AK)

Department of Endocrinology and Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India.

Bipin Sethi (B)

Department of Endocrinology, CARE Hospitals, Hyderabad, Telangana, India.

Vageesh Ayyar (V)

Department of Endocrinology, St John Hospital, Bangalore, Karnataka, India.

Shehla Shaikh (S)

Department of Endocrinology, KGN Institute of Diabetes and Endocrinology, Mumbai, Maharashtra, India.

Parag Shah (P)

Department of Endocrinology and Diabetes, Gujarat Endocrine Centre, Ahmedabad, India.

Sushil Jindal (S)

Department of Endocrinology, Peoples Medical College and Hospital, Bhopal, Madhya Pradesh, India.

Vaishali Deshmukh (V)

Department of Endocrinology, Deshmukh Clinic and Research Centre, Pune, Maharashtra, India.

Joel Dave (J)

Department of Endocrinology, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.

Aslam Amod (A)

Department of Endocrinology, Life Chatsmed Garden Hospital, Durban, South Africa.

Ansumali Joshi (A)

Department of Endocrinology, Kathmandu Diabetes and Thyroid Centre, Kathmandu, Nepal.

Sunil Pokharel (S)

Department of Endocrinology, Alka Hospital, Kathmandu, Nepal.

Faruque Pathan (F)

Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh.

Faria Afsana (F)

Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh.

Indrajit Prasad (I)

Department of Endocrinology, DMCH, Dhaka, Bangladesh.

Moosa Murad (M)

Department of Internal Medicine, Indira Gandhi Memorial Hospital, Malé, Maldives.

Soebagijo Adi Soelistijo (SA)

Department of Endocrinology, Dr Soetomo General Academic Hospital Surabaya, Surabaya, Indonesia.

Johanes Purwoto (J)

Department of Endocrinology, MRCCC Siloam Hospitals, Jakarta, Indonesia.

Zanariah Hussein (Z)

Department of Endocrinology, Putrajaya Hospital, Putrajaya, Malaysia.

Lee Chung Horn (LC)

Department of Diabetes and Endocrinology, Gleneagles Medical Centre, Singapore, Singapore.

Rakesh Sahay (R)

Department of Endocrinology, Osmania Medical College, Hyderabad, India.

Noel Somasundaram (N)

Department of Endocrinology, National Hospital of Sri Lanka, Colombo, Sri Lanka.

Charles Antonypillai (C)

Department of Endocrinology, Teaching Hospital, Kandy, Sri Lanka.

Manilka Sumanathilaka (M)

Department of Endocrinology, National Hospital of Sri Lanka, Colombo, Sri Lanka.

Uditha Bulugahapitiya (U)

Department of Endocrinology, Colombo South Teaching Hospital, Kalubowila, Sri Lanka.

Classifications MeSH