Endocrine Abstracts

Introduction: In Tunisia, the prescription of insulin analogs is increasingly « automatic » by practicians, convinced by this treatment superiority over human insulin in diabetes management. The aim of our study is to determine whether the analogs prescription modalities and advantages are known by the patients, and to assess the factors associated with this knowledge.

Patient and Methods: We conducted a retrospective study including 65 diabetic patients attending the National Institute of Nutrition and on insulin analogs. Information was extracted from medical record and patients interviews.

Results: Fourteen patients had type 1 diabetes, and 51 had type 2 diabetes. Prescription of analogs (primary or switch from human insulin) was the doctor initiative in 86.2% of cases, and was the patients’ in 13.8%. The motivation of this prescription (ie advantages over human insulin) was explained to the patients by the practician in 60.7% of cases. In 58.5% of cases, the patients knew that analogs are more flexible,% 49.2 knew that analogs cause less hypoglycemia, and 10.8% that its injection (insulin pen, solely available to analogs in Tunisia) was less painful than syringe. The percentage knowing the fast analog latency and action duration were respectively 74.2% and 48.5%. There was a statistically significant association between the patient knowledge about hypoglycemia risks and the doctors explanations (P = 0,00). This knowledge was associated with a better diabetes management: less hypoglycemia (P < 0,001) a better HbA1C. (9.62 vs 8.81, P = 0,019). 98.5% of patients manifested their satisfaction with analogs and their desire to keep their prescription.

Conclusion: A substantial proportion of diabetics on analogs didn’t know their advantages and characteristics. This ignorance was partly due to lack of communication with their doctors. Improving this knowledge will lead to a better management of this treatment, and will help to have a better glycemic control.