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In the Footsteps of Insulin Therapy: The Voices of Patients Struggling with Diabetes Complications

Year 2026, Volume: 15 Issue: 1 , 136 - 144 , 28.02.2026
https://doi.org/10.53424/balikesirsbd.1665251
https://izlik.org/JA48CZ57WM

Abstract

Objective: The aim of this study is to investigate the experiences of patients with type 2 diabetes who struggle with diabetes complications regarding insulin use. Materials and Methods: This research was structured with a phenomenological design, one of the qualitative research approaches. The study was conducted with 14 type 2 diabetes patients. The study data were collected through a Personal Information Form and a Semi-Structured Interview Form. MAXQDA-20 was used for data analysis. Results: Three main themes and 10 sub-themes were identified in the study. The impact of complications on treatment sense of control includes sub-themes of “insulin dose increase” and “injection site rotation”. The theme of challenges caused by insulin includes sub-themes “injection side effects”, “psychological challenges”, “social isolation”, “difficulty in carrying insulin”, and “insulin management challenges”. The theme of patients' support needs includes sub-themes of “need for disease-specific support,” “need for psychological support”, and “need for support regarding insulin and its application”. Conclusion: It was found that patients experience physical, psychological, and social challenges related to insulin use, and these challenges affect their daily lives in various ways. Additionally, it was identified that patients required more education and support related to both diabetes management and insulin application.

Ethical Statement

Institution: Bayburt University Non-Interventional Clinical Researches Ethics Committee Date: 16.01.2025, Decision No: 4/1

Supporting Institution

There is no funding fort his article.

Thanks

The authors would like to extend their sincere thanks to anyone who contributed to this study.

References

  • Abu Al-Halaweh, A., Davidovitch, N., Almdal, T. P., Cowan, A., Khatib, S., Nasser-Eddin, L., & Baradia, Z. (2017). Prevalence of type 2 diabetes mellitus complications among palestinians with T2DM. Diabetes & Metabolic Syndrome, 11(Suppl 2), S783–S787. https://doi.org/10.1016/j.dsx.2017.05.017
  • Abu Hassan, H., Tohid, H., Mohd Amin, R., Long Bidin, M. B., Muthupalaniappen, L., & Omar, K. (2013). Factors influencing insulin acceptance among type 2 diabetes mellitus patients in a primary care clinic: a qualitative exploration. BMC Family Practice, 14, 164. https://doi.org/10.1186/1471-2296-14-164
  • Adu, M. D., Malabu, U. H., Malau-Aduli, A. E. O., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. Plos One, 14(6), e0217771. https://doi.org/10.1371/journal.pone.0217771
  • Alnaim, M. M., Alrsaheed, A., Alkhateeb, A. A., Aljaafari, M. M., & Alismail, A. (2023). Prevalence of microvascular complications among patients with type 2 diabetes mellitus who visited diabetes clinics in Saudi Arabia. Saudi Medical Journal, 44(2), 211–217. https://doi.org/10.15537/smj.2023.44.2.20220719
  • Baltacı, A. (2018). Nitel araştırmalarda örnekleme yöntemleri ve örnek hacmi sorunsalı üzerine kavramsal bir inceleme. Bitlis Eren Üniversitesi Sosyal Bilimler Dergisi, 7(1), 231-274.
  • Baruah, M. P., Bhuyan, S. B., Kalra, S., & Tiwaskar, M. H. (2023). Diabetes in India's North East study: Prevailing insulin usage and insulin injection practices amongst type 2 diabetes mellitus patients. The Journal of the Association of Physicians of India, 71(8), 11–12. https://doi.org/10.59556/japi.71.0323
  • Brod, M., Kongsø, J. H., Lessard, S., & Christensen, T. L. (2009). Psychological insulin resistance: patient beliefs and implications for diabetes management. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 18(1), 23–32. https://doi.org/10.1007/s11136-008-9419-1
  • Çalışma TEMD Grubu. (2024). Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve Izlem Kılavuzu. Erişim Adresi: https://file.temd.org.tr/Uploads/publications/guides/documents/diabetesmellitus2024.pdf Erişim Tarihi: 7 Şubat 2024.
  • Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control. Patient Education and Counseling, 99(6), 926–943. https://doi.org/10.1016/j.pec.2015.11.003
  • Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
  • Dirgar, E., Olgun, N. (2021). Kendisine insülin enjeksiyonu uygulayan diyabetlilerin uygulama hataları ve etkileyen faktörlerin belirlenmesi. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 9(2), 523-535.
  • Ellis, K., Mulnier, H., & Forbes, A. (2018). Perceptions of insulin use in type 2 diabetes in primary care: a thematic synthesis. BMC Family Practice, 19(1), 70. https://doi.org/10.1186/s12875-018-0753-2
  • Faselis, C., Katsimardou, A., Imprialos, K., Deligkaris, P., Kallistratos, M., & Dimitriadis, K. (2020). Microvascular complications of type 2 diabetes mellitus. Current Vascular Pharmacology, 18(2), 117–124. https://doi.org/10.2174/1570161117666190502103733
  • Gonzalez, J. S., Tanenbaum, M. L., & Commissariat, P. V. (2016). Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice. The American Psychologist, 71(7), 539–551. https://doi.org/10.1037/a0040388
  • Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105–112. https://doi.org/10.1016/j.nedt.2003.10.001
  • Holmes-Truscott, E., Browne, J. L., & Speight, J. (2016). The impact of insulin therapy and attitudes towards insulin intensification among adults with type 2 diabetes: A qualitative study. Journal of Diabetes and Its Complications, 30(6), 1151–1157. https://doi.org/10.1016/j.jdiacomp.2016.03.027
  • International Diabetes Federation. (2024). Diabetes Facts & Figures. Erişim Adresi: https://idf.org/about-diabetes/diabetes-facts-figures/ Erişim Tarihi: 7 Şubat 2024.
  • Langerman, C., Forbes, A., & Robert, G. (2022). The experiences of insulin use among older people with Type 2 diabetes mellitus: A thematic synthesis. Primary Care Diabetes, 16(5), 614–626. https://doi.org/10.1016/j.pcd.2022.08.008
  • Langerman, C., Forbes, A., & Robert, G. (2024). A qualitative study of the experiences of insulin use by older people with type 2 diabetes mellitus. BMC Primary Care, 25(1), 180. https://doi.org/10.1186/s12875-024-02318-3
  • Patil, M., Sahoo, J., Kamalanathan, S., Selviambigapathy, J., Balachandran, K., Kumar, R., Vivekanandan, M., & Ajmal, K. (2017). Assessment of insulin injection techniques among diabetes patients in a tertiary care centre. Diabetes & Metabolic Syndrome, 11 (Suppl 1), S53–S56. https://doi.org/10.1016/j.dsx.2016.09.010
  • Pradeepa, R., & Mohan, V. (2017). Prevalence of type 2 diabetes and its complications in India and economic costs to the nation. European Journal of Clinical Nutrition, 71(7), 816–824. https://doi.org/10.1038/ejcn.2017.40
  • Rose, P., Beeby, J., & Parker, D. (1995). Academic rigour in the lived experience of researchers using phenomenological methods in nursing. Journal of Advanced Nursing, 21(6), 1123–1129. https://doi.org/10.1046/j.1365-2648.1995.21061123.x
  • Sürücü, H. A., & Arslan, H. O. (2018). Lipohypertrophy in individuals with type 2 diabetes: prevalence and risk factors. Journal of Caring Sciences, 7(2), 67.
  • Tekindal, M., Arsu, Ş.U. (2020). Nitel araştırma yöntemi olarak fenomenolojik yaklaşımın kapsamı ve sürecine yönelik bir derleme. Ufkun Ötesi Bilim Dergisi, 20(1), 153-172.
  • Yönak, A. K., Dayan, A. (2021). Diyabette insülin tedavisi. Turkiye Klinikleri Family Medicine-Special Topics, 12(4), 85-93.

İnsülin Tedavisinin İzinde: Diyabet Komplikasyonları ile Mücadele Eden Hastaların Sesleri

Year 2026, Volume: 15 Issue: 1 , 136 - 144 , 28.02.2026
https://doi.org/10.53424/balikesirsbd.1665251
https://izlik.org/JA48CZ57WM

Abstract

Amaç: Bu çalışmada amaç, diyabet komplikasyonları ile mücadele eden tip 2 diyabetli hastaların insulin kullanımına yönelik deneyimlerini keşfetmektir. Gereç ve Yöntem: Bu araştırma, nitel araştırma yaklaşımlarından fenomenolojik bir desenle yapılandırılmıştır. Çalışma 14 tip 2 diyabetli hasta ile gerçekleştirildi. Araştırma verileri Kişisel Bilgi Formu ve Yarı Yapılandırılmış Görüşme Formu kullanarak toplandı. Veri analizi için MAXQDA-20 kullanıldı.  Bulgular: Çalışmada üç tema ve 10 alt tema bulundu. Olumsuzlukların tedaviye etkisi: Kontrol duygusu teması, “insülin doz artışı” ve “enjeksiyon bölge rotasyonu” alt temalarından oluşmaktadır. İnsülinin yol açtığı zorluklar teması; “enjeksiyon yan etkileri”, “psikolojik zorluk”, “sosyal izolasyon”, “insülin taşıma zorluğu” ve “insülin yönetim zorlukları” alt temalarını içermektedir. Hastaların destek ihtiyaçları teması ise “hastalığa yönelik destek ihtiyacı”, “psikolojiye yönelik destek ihtiyacı” ve “insülin ve uygulamasına yönelik destek ihtiyacı” alt temalarından oluşmaktadır. Sonuç: Hastaların insülin kullanımına bağlı fiziksel, psikolojik ve sosyal zorluklar yaşadığı ve bunun günlük yaşamlarını çeşitli şekillerde etkilediği belirlenmiştir. Ayrıca, hastaların hem diyabet yönetimi hem de insülin uygulamalarına ilişkin daha fazla eğitim ve desteğe ihtiyaç duyduğu tespit edilmiştir. 

Ethical Statement

Kurum: Bayburt Üniversitesi Girişimsel Olmayan Klinik Çalışmalar Etik Kurulu Decision No: 4/1 Tarih: 16.01.2025 Onay numarası: 4/1

Supporting Institution

Bu makale için herhangi bir finansman bulunmamaktadır.

Thanks

Yazarlar, bu çalışmaya katkıda bulunan herkese içten teşekkürlerini sunar.

References

  • Abu Al-Halaweh, A., Davidovitch, N., Almdal, T. P., Cowan, A., Khatib, S., Nasser-Eddin, L., & Baradia, Z. (2017). Prevalence of type 2 diabetes mellitus complications among palestinians with T2DM. Diabetes & Metabolic Syndrome, 11(Suppl 2), S783–S787. https://doi.org/10.1016/j.dsx.2017.05.017
  • Abu Hassan, H., Tohid, H., Mohd Amin, R., Long Bidin, M. B., Muthupalaniappen, L., & Omar, K. (2013). Factors influencing insulin acceptance among type 2 diabetes mellitus patients in a primary care clinic: a qualitative exploration. BMC Family Practice, 14, 164. https://doi.org/10.1186/1471-2296-14-164
  • Adu, M. D., Malabu, U. H., Malau-Aduli, A. E. O., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. Plos One, 14(6), e0217771. https://doi.org/10.1371/journal.pone.0217771
  • Alnaim, M. M., Alrsaheed, A., Alkhateeb, A. A., Aljaafari, M. M., & Alismail, A. (2023). Prevalence of microvascular complications among patients with type 2 diabetes mellitus who visited diabetes clinics in Saudi Arabia. Saudi Medical Journal, 44(2), 211–217. https://doi.org/10.15537/smj.2023.44.2.20220719
  • Baltacı, A. (2018). Nitel araştırmalarda örnekleme yöntemleri ve örnek hacmi sorunsalı üzerine kavramsal bir inceleme. Bitlis Eren Üniversitesi Sosyal Bilimler Dergisi, 7(1), 231-274.
  • Baruah, M. P., Bhuyan, S. B., Kalra, S., & Tiwaskar, M. H. (2023). Diabetes in India's North East study: Prevailing insulin usage and insulin injection practices amongst type 2 diabetes mellitus patients. The Journal of the Association of Physicians of India, 71(8), 11–12. https://doi.org/10.59556/japi.71.0323
  • Brod, M., Kongsø, J. H., Lessard, S., & Christensen, T. L. (2009). Psychological insulin resistance: patient beliefs and implications for diabetes management. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 18(1), 23–32. https://doi.org/10.1007/s11136-008-9419-1
  • Çalışma TEMD Grubu. (2024). Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve Izlem Kılavuzu. Erişim Adresi: https://file.temd.org.tr/Uploads/publications/guides/documents/diabetesmellitus2024.pdf Erişim Tarihi: 7 Şubat 2024.
  • Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control. Patient Education and Counseling, 99(6), 926–943. https://doi.org/10.1016/j.pec.2015.11.003
  • Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
  • Dirgar, E., Olgun, N. (2021). Kendisine insülin enjeksiyonu uygulayan diyabetlilerin uygulama hataları ve etkileyen faktörlerin belirlenmesi. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 9(2), 523-535.
  • Ellis, K., Mulnier, H., & Forbes, A. (2018). Perceptions of insulin use in type 2 diabetes in primary care: a thematic synthesis. BMC Family Practice, 19(1), 70. https://doi.org/10.1186/s12875-018-0753-2
  • Faselis, C., Katsimardou, A., Imprialos, K., Deligkaris, P., Kallistratos, M., & Dimitriadis, K. (2020). Microvascular complications of type 2 diabetes mellitus. Current Vascular Pharmacology, 18(2), 117–124. https://doi.org/10.2174/1570161117666190502103733
  • Gonzalez, J. S., Tanenbaum, M. L., & Commissariat, P. V. (2016). Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice. The American Psychologist, 71(7), 539–551. https://doi.org/10.1037/a0040388
  • Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105–112. https://doi.org/10.1016/j.nedt.2003.10.001
  • Holmes-Truscott, E., Browne, J. L., & Speight, J. (2016). The impact of insulin therapy and attitudes towards insulin intensification among adults with type 2 diabetes: A qualitative study. Journal of Diabetes and Its Complications, 30(6), 1151–1157. https://doi.org/10.1016/j.jdiacomp.2016.03.027
  • International Diabetes Federation. (2024). Diabetes Facts & Figures. Erişim Adresi: https://idf.org/about-diabetes/diabetes-facts-figures/ Erişim Tarihi: 7 Şubat 2024.
  • Langerman, C., Forbes, A., & Robert, G. (2022). The experiences of insulin use among older people with Type 2 diabetes mellitus: A thematic synthesis. Primary Care Diabetes, 16(5), 614–626. https://doi.org/10.1016/j.pcd.2022.08.008
  • Langerman, C., Forbes, A., & Robert, G. (2024). A qualitative study of the experiences of insulin use by older people with type 2 diabetes mellitus. BMC Primary Care, 25(1), 180. https://doi.org/10.1186/s12875-024-02318-3
  • Patil, M., Sahoo, J., Kamalanathan, S., Selviambigapathy, J., Balachandran, K., Kumar, R., Vivekanandan, M., & Ajmal, K. (2017). Assessment of insulin injection techniques among diabetes patients in a tertiary care centre. Diabetes & Metabolic Syndrome, 11 (Suppl 1), S53–S56. https://doi.org/10.1016/j.dsx.2016.09.010
  • Pradeepa, R., & Mohan, V. (2017). Prevalence of type 2 diabetes and its complications in India and economic costs to the nation. European Journal of Clinical Nutrition, 71(7), 816–824. https://doi.org/10.1038/ejcn.2017.40
  • Rose, P., Beeby, J., & Parker, D. (1995). Academic rigour in the lived experience of researchers using phenomenological methods in nursing. Journal of Advanced Nursing, 21(6), 1123–1129. https://doi.org/10.1046/j.1365-2648.1995.21061123.x
  • Sürücü, H. A., & Arslan, H. O. (2018). Lipohypertrophy in individuals with type 2 diabetes: prevalence and risk factors. Journal of Caring Sciences, 7(2), 67.
  • Tekindal, M., Arsu, Ş.U. (2020). Nitel araştırma yöntemi olarak fenomenolojik yaklaşımın kapsamı ve sürecine yönelik bir derleme. Ufkun Ötesi Bilim Dergisi, 20(1), 153-172.
  • Yönak, A. K., Dayan, A. (2021). Diyabette insülin tedavisi. Turkiye Klinikleri Family Medicine-Special Topics, 12(4), 85-93.
There are 25 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases Nursing​
Journal Section Research Article
Authors

Serap Çetinkaya Özdemir 0000-0001-7706-4748

Ebru Sönmez Sarı 0000-0001-7337-4853

Vahide Semerci Çakmak 0000-0003-3481-9500

Ahmet Seven 0000-0002-2599-1918

Submission Date March 25, 2025
Acceptance Date January 3, 2026
Publication Date February 28, 2026
DOI https://doi.org/10.53424/balikesirsbd.1665251
IZ https://izlik.org/JA48CZ57WM
Published in Issue Year 2026 Volume: 15 Issue: 1

Cite

APA Çetinkaya Özdemir, S., Sönmez Sarı, E., Semerci Çakmak, V., & Seven, A. (2026). In the Footsteps of Insulin Therapy: The Voices of Patients Struggling with Diabetes Complications. Balıkesir Sağlık Bilimleri Dergisi, 15(1), 136-144. https://doi.org/10.53424/balikesirsbd.1665251

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