Background:

Approximately 60,000 Victorian adults use insulin to manage type 2 diabetes (T2D), and this number is increasing. Based on enquiries to the Diabetes Victoria telephone Helpline, many people with T2D have unmet information needs about managing insulin. Callers have expressed concerns about illness, exercise and travel and are unsure about the management of out-of-target glycaemia.

Aim: We aimed to explore insulin-related knowledge, attitude and behaviours of adults with T2D using insulin in order to inform the development of self-management information.

Methods:

Diabetes Victoria members with insulin-treated T2D were invited to complete an online survey asking about their insulin use and self-management. Participation was voluntary.

Results:

A total of 219 people completed the survey: 61% male; mean age 67.1 years; range 29-91; 68% had T2D for more than 10 years. 50% had used insulin for more than 5 years.

 Findings from the survey showed that:

• 75% of respondents reported changing insulin doses for "high" blood glucose levels (BGLs) but only 57% made adjustments for low BGLs
• Fewer adjusted insulin for eating differently (39%) or exercise (37%)
• 76% could not explain why their BGLs were “high”, whereas 51% could not explain “low” BGLs
• 70% stated they worried about “high” BGLs, however 53% were not worried about low blood glucose levels
• 59% worried about weight gain due to insulin use
• Finally, 71% of respondents indicated they would attend a workshop to learn more about insulin use.

Conclusion:

Our findings confirmed knowledge gaps around insulin use and self-management; even among long-term insulin users. The responses indicated people were less concerned about low BGL, and less likely to adjust for hypoglycaemia which is concerning given long-term insulin use increases the risk of severe hypoglycaemia. This demonstrates the need to develop and trial a structured self-management intervention for people with T2D using insulin.