Ann Clin Diabetes Endocrinol | Volume 4, Issue 1 | Research Article | Open Access

Psychological Insulin Resistance in Adults with Type 2 Diabetes Mellitus

Keeler B, Meal A, Jiwani SI, Gyasi-Antwi P and Adams GG

Department of Medicine and Health Sciences, The University of Nottingham, Queen's Medical Centre, UK

*Correspondance to: Adams GG 

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Introduction: This systematic review explores Psychological Insulin Resistance (PIR) in adults with Type 2 Diabetes (T2DM). It examines patient’s perceptions of the barriers to insulin therapy initialization, and restrictions on activities of daily-living and patient perception of its relationship to disease severity. Materials and Methods: Six online electronic databases, PubMed NCBI, CINAHL, Cochrane, EMBASE, Wiley and Ovid, were systematically searched using keyword terminology and the PICOS tool focused on the Population, Intervention, Comparison, Outcomes and Study type to identify suitable primary research studies to be included. The quality of the included literature was appraised using the Critical Appraisal Skills Program (CASP) framework for eligibility. Selected studies were reviewed, and themes were identified as appropriate areas of exploration. Results: A total of 3,764 records were identified through database searching and 487 studies screened for inclusion consideration. Of these, 54 studies were appraised using a critical appraisal system, where 10 papers were selected for inclusion. Within these 10 studies, three main themes were identified: 1) Injection anxiety and associated pain, 2) Restrictions to daily activities and 3) Patient perceptions of disease severity. Conclusion: Causal factors for PIR in adults with Type 2 Diabetes Mellitus were investigated. Measuring and quantifying PIR took the form of qualitative, cross-sectional, editorial and review based studies. The presentation of patient perceptions of injection fear and anxiety, restrictions to daily life and disease severity were identified as common recurring themes within the selected studies.


Psychological Insulin Resistance (PIR); Type 2 diabetes; Insulin; Hypoglycemia


Keeler B, Meal A, Jiwani SI, Gyasi- Antwi P, Adams GG. Psychological Insulin Resistance in Adults with Type 2 Diabetes Mellitus. Ann Clin Diabetes Endocrinol. 2021; 4(1):1021.

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