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Psychological insulin resistance can result in delays in treatment initiation. The aim of our study is to find the prevalence of psychological insulin resistance among patients at a tertiary hospital in Sri Lanka. Materials and methods: A prospective cross sectional survey was conducted at General Medical clinic, Colombo North Teaching Hospital, using a pre-tested, intervieweradministered 25 question survey adapted from Insulin Treatment Appraisal Scale (ITAS) among a consequent sample of 358 patients. Results: Majority (52.2%) of patients considered commencement of insulin therapy as personal failure (P=0.0001). Gender had a significant impact on the fear for needle with females having a higher negative score (3.39) compared to males (3.18) (P=0.040). Overall negative appraisal for insulin was similar in both genders. 49.1% feared that once insulin is started it is needed permanently while 0.8% opposed it. Statistically significant difference was not found between the total mean score for negative items among patients on OHDs (3.19) and patients on insulin (3.10) (P=0.133). Perception of social stigmata and perception of injection conveyed higher negative appraisal. Educational level and duration of diabetes did not have significant influence on insulin perception. Conclusion: Health care workers need to probe into the perceptions that worry the patients and focus on groups with more negative appraisal towards insulin.

Psychological Resistance for Insulin Therapy Among Patients with type 2 Diabetes Mellitus: a Cross Sectional Survey