Insulin initiation in Type 2 diabetes mellitus outpatients – data from the multicentre evaluation of type 2 diabetes mellitus outpatients on insulin therapy in Nigeria (METOIN study)

  • Marcellinus O Nkpozi Department of Internal Medicine, Abia State University Teaching Hospital, Aba, Nigeria https://orcid.org/0000-0001-7709-3979
  • GE Bozimo Department of Medicine, Federal Medical Centre, Yenogoa, Nigeria
  • BC Ubani Department of Internal Medicine, University of Uyo Teaching Hospital, Uyo, Nigeria
  • FA Owolabi Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile Ife, Nigeria
  • K Akhidue Department of Medicine, University of Portharcourt Teaching hospital, Portharcourt, Nigeria
  • CM Ezeude Department of Medicine, Nnamdi Azikiwe University Teaching hospital, Nnewi, Nigeria
  • SU Ogbonna Department of Medicine, Federal Medical Centre, Umuahia, Nigeria

Abstract

People living with type 2 diabetes mellitus (T2DM) have relative insulin deficiency and, therefore, have options to insulin therapy. To be on insulin alone or in combination with other therapies in type 2 DM outpatients is a choice made personalized for each patient. Published literature on the insulin initiation patterns among T2DM outpatients in Nigeria is scanty. The objective of this study, therefore, is to bridge this gap in knowledge. This was a prospective cross sectional study conducted in five tertiary health facilities in Nigeria in which consenting type 2 DM outpatients on insulin therapy alone or in combination with other therapies and who meet the inclusion criteria for the study were recruited. Relevant data relating to insulin use initiation by the patients were analyzed using Statistical Package for Social Sciences (SPSS) version 23.0 software. A total of 268 outpatients living with type 2 DM on insulin therapy, made up of 116 (43.3%) male and 152 (56.7%) females participated in the study. Only 55 (20.5%) of the patients started insulin at onset of diagnosis of T2DM while 46 (17.2%) of the patients started insulin therapy after 5 years of living with T2DM. The duration of living with DM before insulin initiation and the patient's highest level of education were not statistically significant. Insulin initiation was delayed several months to years after diagnosis of T2DM by predominantly endocrinologists in tertiary health facilities but it was initiated in 19 (7.1%) of the T2DM outpatients by primary care physicians (GPs) in peripheral hospitals. It is recommended that diabetes education be intensified for T2DM patients to appreciate the key role of insulin therapy in diabetes care.


Keywords: insulin initiation, type 2 diabetes mellitus outpatients, Nigeria.

Keywords: insulin initiation, type 2 diabetes mellitus outpatients, Nigeria

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Author Biographies

Marcellinus O Nkpozi, Department of Internal Medicine, Abia State University Teaching Hospital, Aba, Nigeria

Endocrinology, Diabetes and Metabolism Unit, Department of Internal Medicine, Abia State University Teaching Hospital, ABSUTH, Aba, Nigeria

GE Bozimo, Department of Medicine, Federal Medical Centre, Yenogoa, Nigeria

Department of Medicine, Federal Medical Centre, Yenogoa, Nigeria

BC Ubani, Department of Internal Medicine, University of Uyo Teaching Hospital, Uyo, Nigeria

Department of Internal Medicine, University of Uyo Teaching Hospital, Uyo, Nigeria

FA Owolabi, Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile Ife, Nigeria

Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile Ife, Nigeria

K Akhidue, Department of Medicine, University of Portharcourt Teaching hospital, Portharcourt, Nigeria

Department of Medicine, University of Portharcourt Teaching hospital, Portharcourt, Nigeria

CM Ezeude, Department of Medicine, Nnamdi Azikiwe University Teaching hospital, Nnewi, Nigeria

Department of Medicine, Nnamdi Azikiwe University Teaching hospital, Nnewi, Nigeria

SU Ogbonna, Department of Medicine, Federal Medical Centre, Umuahia, Nigeria

Department of Medicine, Federal Medical Centre, Umuahia, Nigeria

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Nkpozi MO, Bozimo G, Ubani B, Owolabi F, Akhidue K, Ezeude C, Ogbonna S. Insulin initiation in Type 2 diabetes mellitus outpatients – data from the multicentre evaluation of type 2 diabetes mellitus outpatients on insulin therapy in Nigeria (METOIN study). JDDT [Internet]. 15Nov.2022 [cited 9Dec.2022];12(6):120-3. Available from: https://jddtonline.info/index.php/jddt/article/view/5810