The role of psychological insulin resistance in diabetes self-care management.
Ancho Lim, Youngshin Song
PMID 32257276WHAT IT FOUND
Older adults with type 2 diabetes who felt more confident managing their disease reported better self-care.
Insulin reluctance was partly associated with that link, so diabetes education should address insulin barriers as well as daily self-care skills.
Key findings
01Diabetes self-care was positively associated with diabetes self-efficacy (r = .53) and negatively associated with psychological insulin resistance (r = −.33).
02Self-efficacy had a direct standardized association with self-care (β = 0.75) and an indirect standardized association through psychological insulin resistance (β = 0.06).
03Insulin treatment was recommended for 121 participants (37.1%), but only 88 (27%) were receiving it.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured associations at one time point, so it cannot show that higher self-efficacy causes better self-care or that lower insulin resistance causes better self-care. Participants were recruited from two sites in South Korea using convenience sampling, and the sample did not include diverse ethnic and racial groups. The model fit did not meet all recommended thresholds. All variables were self-reported, and the study excluded people with dementia or difficulty answering questions. Psychological insulin resistance relates to insulin, while diabetes self-care includes diet, exercise, glucose monitoring and foot care.
Declared interests
There are no conflicts of interest. The study was funded by the National Research Foundation of Korea.
The easy way to misread this
Do not read the partial mediation result as proof that reducing insulin reluctance will improve diabetes self-care. The study was cross-sectional, used convenience sampling, and the model fit did not meet all recommended thresholds.