RESUMO
@#Introduction: The prevalence of diabetes shows an increasing trend in Malaysia. Insulin is effective towards glycaemic control, but refusal of insulin by type 2 diabetes mellitus (T2DM) patients delay initiation of insulin therapy. This study assessed the prevalence and predictors of insulin refusal among insulin-naïve T2DM patients under all public health clinics in Segamat. Methods: This was a multi-centre, cross-sectional study conducted in 11 public health clinics in Segamat. Data were collected from September until November 2019 by systematic random sampling using a validated self-administered questionnaire. Factors associated with reluctance to use insulin were examined using logistic regression. Results: Out of 295 insulin-naïve T2DM patients recruited in this study, 234 (79.3%) rejected insulin treatment. The two foremost reasons were being unconfident of injecting insulin (83.3%) and feeling of failure to control the disease (82.1%). Educational background and gender were significantly associated with insulin treatment refusal. Patients with no formal or only primary education were found to be 1.97 times more likely to refuse insulin (adjusted OR 1.97, 95% CI 1.09-3.56, p=0.025), and female patients were 1.82 times more likely to refuse insulin therapy than male patients (adjusted OR 1.82, 95% CI 1.02-3.22, p=0.041). Conclusion: The prevalence of insulin refusal is high in public health clinics in Segamat. Besides counselling, intervention steps should be taken to improve insulin acceptance by targeting the most typical reasons for insulin refusal in our setting.