title: Factors associated with psychological insulin resistance in individuals with type 2 diabetes.
abstract: OBJECTIVE
  To describe the predictive relationships of selected sociodemographic, biomedical, and psychosocial variables to reluctance to use insulin among patients with type 2 diabetes.
  
  
  METHODS
  A total of 178 patients with type 2 diabetes participated in this cross-sectional, observational study. Data were obtained by patient interview using validated measures of diabetes attitude, knowledge, self-efficacy, care communication, and perceived barriers to treatment, as well as sociodemographic and biomedical data.
  
  
  RESULTS
  Women and ethnic minorities with type 2 diabetes have more psychological barriers to insulin treatment (P < 0.05). The final regression model showed that individuals who believed in the value of tight glucose control, had strong self-efficacy, and had better interpersonal processes with their healthcare providers were less reluctant to use insulin treatment (R(2) = 0.403; P < 0.0001).
  
  
  CONCLUSIONS
  Diabetes self-efficacy and better interaction with clinicians were important in decreasing patients' reluctance to use insulin, known as psychological insulin resistance.
authors.affiliation: University of California, San Francisco, School of Nursing, San Francisco, California, USA. soohnam@gmail.com
authors.forename: Soohyun
authors.initials: S
authors.lastname: Nam
authors.forename: Catherine
authors.initials: C
authors.lastname: Chesla
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Stotts
authors.forename: Lisa
authors.initials: L
authors.lastname: Kroon
authors.forename: Susan L
authors.initials: SL
authors.lastname: Janson
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D016312:Treatment Refusal / Q000208:ethnology / Q000523:psychology*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin