title: [Satisfaction of patients with type 2 diabetes mellitus after starting treatment with insulin].
abstract: OBJECTIVE
  The objective of this study is to evaluate if overcoming the barrier of starting treatment with insulin can lead to better clinical control and a higher level of patient satisfaction with their treatment.
  
  
  METHODS
  This is an observational, multicentre study of patients diagnosed with DM2 who attended primary care centres with poor glycaemic control (A1c≥8%) under treatment with oral antidiabetic drugs (OADs), and who were given motivational treatment to overcome their fear of injections, and started treatment with insulin. The level of satisfaction with the treatment was evaluated using the Diabetes Treatment Satisfaction Questionnaire (DTSQ). The questionnaire was used before initiating the treatment with insulin and in the follow-up visit (3-4 months from the beginning of treatment with basal insulin).
  
  
  RESULTS
  A total of 573 patients with a mean age of 64±10 years were recruited. The overall mean score from the DTSQs satisfaction questionnaire was 18.3±6.3, and the change of treatment led to an improvement in patient satisfaction compared to the previous treatment (DTSQc mean score 8.8±5.9). A1c dropped from an initial value of 8.7% (SD 0.8) to 7.5% (SD 0.7) (P<.001). The frequency of hyperglycaemic episodes perceived by the patients was significantly lower after they overcame their fear of injections (35.6% compared to 11.5%; P<.001), but no statistically significant differences were found in the frequency of hypoglycaemic episodes (32% compared to 35%; P=.059).
  
  
  CONCLUSIONS
  In patients with DM2 poorly controlled with OADs, overcoming a fear of injections and starting treatment with insulin was associated with an overall improvement in satisfaction with the new treatment, and decreased the perception of hyperglycaemic episodes. Glycaemic control and the metabolic profile of the patients also improved to a statistically significant degree with the change of treatment.
authors.affiliation: Centro de Salud Ciudad Jardín, Distrito Sanitario Málaga-Guadalhorce, Málaga, España. Electronic address: jmancerar@semergen.es.
authors.forename: J
authors.initials: J
authors.lastname: Mancera-Romero
authors.affiliation: Centro de Salud San Roque, Badajoz, España.
authors.forename: F
authors.initials: F
authors.lastname: Carramiñana-Barrera
authors.affiliation: Centro de Salud Ciudad Jardín, Distrito Sanitario Málaga-Guadalhorce, Málaga, España.
authors.forename: L
authors.initials: L
authors.lastname: Muñoz-González
authors.affiliation: Centro de Salud San Roque, Badajoz, España.
authors.forename: P
authors.initials: P
authors.lastname: Guillén-Álvarez
authors.affiliation: Centro de Salud San Roque, Badajoz, España.
authors.forename: D
authors.initials: D
authors.lastname: Murillo-García
authors.affiliation: Centro de Salud Ciudad Jardín, Distrito Sanitario Málaga-Guadalhorce, Málaga, España.
authors.forename: M R
authors.initials: MR
authors.lastname: Sánchez-Pérez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007267:Injections / Q000523:psychology; D049528:Insulin, Long-Acting / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting
keywords: Diabetes mellitus tipo 2; Insulin; Insulina; Patient satisfaction; Satisfacción del paciente; Type 2 diabetes mellitus