1519-P: A Study on Epidemiological Barriers in Usage of Insulin among Rural South Indians

Introduction: Diabetes mellitus (DM) remains the iceberg disease in rural areas with large number of subjects remaining undiagnosed. India is the diabetes capital with home to 72.9 million diabetic people. Methodology: Our cross-sectional observational and analytical survey studied 516 subjects with uncontrolled type 2 DM (HbA1c >9%) in the 9 villages (having 35,000 population) at Rural health centre, Veleru of Dr. PSIMS and RF, Krishna district, Andhra Pradesh, South India which is a predominantly rice eating population and analyzed the socio-demographic factors influencing insulin administration. Participants were assessed through a pre-tested structured questionnaire to elicit awareness regarding insulin usage. Results: Though 40.3% were prescribed insulin at some point of time, only 10.1% subjects were taking it. Awareness of diabetes was lacking in 67.8% and that of insulin in 54.1%. Commonest reason for avoiding insulin was fear of injections (31.8%), unawareness of insulin technique in 25.8%, lack of facilities to store insulin in 19.8% subjects, lack of access to pharmacy in 9.3%, unsure about correct timing in 20.2%, concerned about proper dosage measurements in 1.9%, but only 3.9% were concerned about cost. Conclusion: Proper awareness programs can significantly increase effective and regular use of insulin in diabetes subjects.