[Barriers of the initiation of insulin treatment in type 2 diabetic patients - conquering the "psychological insulin resistance"].

Abstract:

:Type 2 diabetes is a progressive disease and its consequence is the gradual decrease of endogenous insulin secretion to a very low level. Beyond this point, without insulin it is not possible to achieve proper metabolic compensation. The authors are trying to explain why the insulin therapy is often delayed in type 2 diabetic patients despite existing guidelines about its initiation and continuation. The causes of delay can be divided into two groups. One is the fear and disagreement of the patients (psychological insulin resistance - PIR) arising from different cognitive, emotional and other reasons. The second is the "clinical inertia", when the physicians are not able to explain in an effective and persuasive way the rationale and necessity of insulin treatment to their patients. The common background of both causes is the lack of sufficient knowledge about the pathogenesis of type 2 diabetes and the rationale of insulin treatment together with an insufficient level of communication between doctor and patient. The authors see the solution in the improvement of pre- and postgradual education of doctors and other health care providers (nurses, educators, psychologists), in their mutual cooperation and the translation of their knowledge towards a system of successful patient education. Orv Hetil. 2019; 160(3): 93-97. :Absztrakt: A 2-es típusú diabetes mellitus progresszív betegség, amelynek következtében az endogén inzulin szekréciója fokozatosan nagyon alacsony szintre csökken. Amennyiben ez bekövetkezik, akkor inzulin nélkül a kezelés nem képes biztosítani a megfelelő anyagcserekontrollt. A szerzők annak a problémának keresik az okát, hogy miért késik gyakran az inzulinkezelés bevezetése a 2-es típusú cukorbetegekben annak ellenére, hogy ennek alapelvei részletesen ki vannak dolgozva. A késés okait két csoportra lehet osztani: az egyik a betegek félelme és ellenkezése (pszichológiai inzulinrezisztencia – PIR) különböző kognitív, emocionális és más okokból. A másik a „klinikai inercia”, amikor az orvos nem képes érthetően és meggyőzően elmagyarázni betegének, hogy miért szükséges az inzulinkezelés. A két oknak közös háttere van, és ez a 2-es típusú diabetes patogenezisének és az inzulinkezelés szükségessének elégtelen ismerete, illetve az orvos–beteg kommunikáció hiányossága. A szerzők a megoldást az orvosok és segítőtársaik (nővérek, edukátorok, pszichológusok) hatékonyabb graduális és posztgraduális oktatásában, a szakemberek együttműködésében és az ehhez kapcsolódó hatásos betegoktatásban látják. Orv Hetil. 2019; 160(3): 93–97.

journal_name

Orv Hetil

journal_title

Orvosi hetilap

authors

Rácz O,Linková M,Jakubowski K,Link R,Kuzmová D

doi

10.1556/650.2019.31269

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

93-97

issue

3

eissn

0030-6002

issn

1788-6120

journal_volume

160

pub_type

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