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Licensed Unlicensed Requires Authentication Published by De Gruyter January 15, 2020

Patients’ characteristics and their adherence to insulin therapy

  • Yunti Fitriani ORCID logo , Liza Pristianty ORCID logo EMAIL logo and Andi Hermansyah ORCID logo



The prevalence of type 2 diabetes mellitus (DMT2) in Indonesia increased significantly from 6.9% (2013) to 8.5% (2018), putting Indonesia in top six countries in the world with maximum DMT2 patients. Patients with uncontrolled DMT2 are at risk for complications. As such, insulin is often administered to keep the levels under control. Unfortunately, poor adherence to insulin therapy is common, reflecting some factors that may affect the therapy. The aim of this study was to identify and analyze the characteristics of patients contributing to adherence to insulin therapy among DMT2 outpatients using the Health Belief Model (HBM) approach.


A cross-sectional survey was conducted on a sample of 84 DMT2 outpatients in a private hospital in Surabaya between April and May 2019. Respondents were selected using the accidental sampling technique. Data were analyzed using descriptive analysis and chi-square.


The level of respondents’ adherence was high (73.8%). There was no significant relationship between sex, age, level of education, occupation, and duration of use and patient adherence. Using the HBM approach, this study showed a significant relationship between the five components of HBM (perceived susceptibility, perceived severity, perceived benefit, perceived barrier and perceived self-efficacy) and patient adherence.


Patient adherence was influenced primarily by patient belief to the therapy of insulin. The characteristics of patients had no effect on adherence, yet further research is recommended to examine such adherence to a different population.


The authors express their gratitude to Surabaya PHC Hospital for providing the opportunity to conduct research. The authors also appreciate DM patients who were willing to be respondents in this study.

  1. Research funding: Research funds obtained from researchers' private funds.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The Health Research Ethics Committee of Surabaya PHC Hospital issued a statement passing the ethical review with No. 004/KEPK/RSPS-2019, issued on April 16, 2019, by the Chairman of the KEPK PHC Hospital Surabaya.


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Received: 2019-11-03
Accepted: 2019-12-10
Published Online: 2020-01-15

© 2019 Walter de Gruyter GmbH, Berlin/Boston

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