Exploring patients’ perceptions for insulin therapy in type 2 diabetes: a Brazilian and Canadian qualitative study

Camila Guimarães², Carlo A Marra¹, Sabrina Gill¹, Graydon Meneilly¹, Scot Simpson³, Ana LPC Godoy², Maria Cristina Foss de Freitas², Regina HC Queiroz², Larry Lynd¹

¹The University of British Columbia, Canada; ²University of São Paulo, Brazil; ³The University of Alberta, Canada

Objective: To explore which attributes of insulin therapy drive patients’ preferences for management in Canada and Brazil.

Methods: A qualitative design was implemented in which a total of 32 patients with type 2 diabetes from Canada and Brazil, were interviewed in one of the 4 focus groups, or 16 individual interviews. Eighteen participants (56%) were women and fourteen participants (44%) were men (15 insulin nonusers and 17 insulin users). Two focus groups of 4 participants each and 9 individual interviews were conducted in Brazil. In Canada, 2 focus groups of 4 participants each and 7 individual interviews were conducted. A framework analysis was used to analyse all data.

Results: Brazilian participants, when considering two insulin treatments, would prefer the one that had fewer side-effects (specially hypoglycemia events), was noninjectable, had the lowest cost and was most effective. Meanwhile, Canadian participants would prefer a treatment that had fewer side-effects (specially weight gain), was less invasive, was more convenient and was most effective.

Conclusions: Finding the insulin-delivery system and the attributes of insulin therapy that best meet patients’ preferences may lead to improved control, through improved compliance, which may ultimately reduce the financial burden of the disease and improve quality of life.

Keywords: type 2 diabetes, insulin administration, glycemic control, weight gain, hypoglycemia, qualitative study, patients’ preferences