Psychological Insulin Resistance Prevalence Among Type II Diabetes Patients and its Association with Depression and Anxiety in Chogoria Hospital
| dc.contributor.author | Maithya, Lilian Kamita | |
| dc.date.accessioned | 2026-04-20T09:21:14Z | |
| dc.date.issued | 2025-11 | |
| dc.description | Full text | |
| dc.description.sponsorship | Abstract Psychological insulin resistance (PIR) is a major obstacle to effective Type 2 Diabetes Mellitus (T2DM) management because it delays or prevents the initiation and continuation of insulin therapy. This study, conducted at PCEA Chogoria Hospital in rural Kenya, examined the prevalence of PIR among adults with T2DM and assessed its relationship with glycemic control, measured through glycated hemoglobin (HbA1c), as well as its association with depression and anxiety. The study used a descriptive cross sectional design and included 121 participants with T2DM. Data collection employed validated instruments: the Insulin Treatment Appraisal Scale (ITAS) to measure PIR, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety screening, and the Patient Health Questionnaire 9-item scale (PHQ-9) for depression assessment. Chi square tests and Fisher‟s exact tests were used to evaluate associations between PIR, HbA1c categories, and mental health measures. PIR was present in 62.8 percent of participants, indicating substantial hesitation to initiate insulin therapy. Prominent contributors to PIR included feelings of personal responsibility for the illness, reported by 77 percent, and fear of injections, reported by 58 percent. These findings reflect significant emotional and practical barriers to insulin acceptance. Poor glycemic control was common. A total of 42.1 percent had HbA1c values between 7.1 percent and 9.0 percent, and 20.7 percent had values above 9.0 percent. Despite this, no statistically significant relationship was found between PIR and HbA1c levels (p = 0.226). Associations between PIR and mental health indicators were mixed. Chi-square analyses suggested significant associations between PIR and both depression (p = 0.023) and anxiety (p = 0.049). Fisher‟s exact tests did not confirm these findings, with p-values of 0.287 for depression and 1.0 for anxiety. These discrepancies may reflect limited statistical power due to the relatively small sample and the low number of participants screening positive for mental health conditions. The results highlight the importance of psychological factors such as self-blame, emotional distress, and fear of injections in shaping resistance to insulin therapy. Integrated strategies that combine mental health support, structured diabetes education, and individualized counseling are needed to reduce PIR. Incorporating these approaches into routine diabetes care in rural Kenya may enhance willingness to initiate insulin, improve glycemic control, and reduce barriers to effective T2DM management | |
| dc.identifier.uri | https://ir.kabarak.ac.ke/handle/123456789/1779 | |
| dc.language.iso | en | |
| dc.publisher | Kabarak University | |
| dc.subject | Insulin Resistance | |
| dc.subject | Diabetes | |
| dc.subject | Insulin Therapy | |
| dc.title | Psychological Insulin Resistance Prevalence Among Type II Diabetes Patients and its Association with Depression and Anxiety in Chogoria Hospital | |
| dc.type | Thesis |