| Abstrakt: |
Background: Type 2 diabetes has been proven to be a complex, heterogenous disorder with a dramatically increasing prevalence worldwide. Early use of insulin in the management of poorly controlled diabetes has been recommended to prevent and reduce the long term diabetes complications. However, various factors are delaying the insulin initiation by healthcare providers and by patients themselves. One of the main barriers is psychological insulin resistance. As the Roma community is one of the most vulnerable social groups around the world, and their health status is considered to be disproportionately burdened compared with non-Roma in many European countries, the purpose of this study is to examine the different concepts regarding diabetes and pain and the psychological resistance to insulin use between Roma and non-Roma patients, for clarifying the factors creating barriers to insulin use in poorly controlled diabetes. Methods: 100 patients participated in the study and were divided into two groups: 50 from the Roma community (aged 40-60 years old) and 50 of Greek origin (aged 50-70 years old). Between the two groups, there were large statistical differences in various demographics, especially smoking (p=0.000), and level of education (p=0.000). Roma people show a higher incidence of hyperlipidemia, hypertension and problems associated with uncontrolled type 2 diabetes. When asked if they are followed up by a doctor, most Roma patients gave a negative answer, while Greek patients answered yes (p = 0.000), most of them preferring a private physician, in contrast to Roma patients who preferred the hospital’s outpatient department (p = 0.000). Results: Regarding the responses to the questionnaires, there are large variations in scores. In the quality of life questionnaire there were few statistical significant differences between the two groups. The BIT’s results were different between the two ethnic groups and with some differences between genders as well. Comparing the overall scores of the questionnaires between the two groups, we conclude that there are big differences with the Roma having higher (worse) scores in the quality of life questionnaire, and especially regarding the barriers to insulin use. Conclusions: Thus, there are large differences of diabetes management with insulin between the two groups, since Roma patients feel that their diabetes deeply affect their quality of life. Scientific impact and future research: Physicians could address their concerns aiming to modify their patients’ misconceptions towards insulin therapy, especially for ethnic groups, such as Roma, whose promotion of health is one of the main priorities of the European Union. [ABSTRACT FROM AUTHOR] |
