Background: Lack of adherence to insulin therapy is common among patients with type 1 diabetes. Factors associated with insulin omission in adult persons with type 1 diabetes in Latin America have not been studied in detail. Objectives: To investigate factors associated with insulin nonadherence including the presence of psychological disorders (disordered eating behaviors and depression) in adult patients with type 1 diabetes. Methods: Cross-sectional study including 104 consecutive adults (≥18 years old) attending a tertiary care center in Mexico City. Adherence to insulin therapy was measured with a specific item in a questionnaire. Sociodemographic data and factors related to insulin omission, including validated questionnaires to evaluate disordered eating behavior and depression, were collected and compared between the nonadherent and adherent groups with parametric or nonparametric statistical tests, as appropriate. Results: We classified 51 (49.1%) patients as nonadherent and 53 (50.9%) as adherent. Adherent subjects reported that they planned their activities around insulin application more often than the nonadherent subjects did (43.4 vs. 23.5%, p = 0.032). In a logistic regression model, fear of hypoglycemia (OR = 11.39) and economic reasons (OR = 6.02) were independently associated with insulin adherence. Presence of disordered eating behavior was identified in 14.4% of subjects, the majority belonging to the nonadherent group. Conclusions: Only 50% of the patients with type 1 diabetes were adherent. The principal factors associated with nonadherence were economic reasons and fear of hypoglycemia.

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墨西哥 1 型糖尿病患者胰岛素不依从性的相关因素

背景：缺乏对胰岛素治疗的依从性在 1 型糖尿病患者中很常见。尚未详细研究拉丁美洲成人 1 型糖尿病患者中与胰岛素缺失相关的因素。目的：研究与胰岛素不依从性相关的因素，包括成年 1 型糖尿病患者是否存在心理障碍（饮食行为紊乱和抑郁）。方法：横断面研究包括 104 名连续在墨西哥城三级医疗中心就诊的成人（≥18 岁）。对胰岛素治疗的依从性是通过问卷中的一个特定项目来衡量的。与胰岛素遗漏相关的社会人口学数据和因素，包括用于评估饮食失调和抑郁症的经过验证的问卷，收集和比较非依从组和依从组之间的参数或非参数统计检验，视情况而定。结果：我们将 51 (49.1%) 名患者分类为非依从性，53 (50.9%) 名患者为依从性。依从的受试者报告说，他们比不依从的受试者更频繁地围绕胰岛素应用计划他们的活动（43.4 对 23.5%，p = 0.032）。在逻辑回归模型中，对低血糖的恐惧 (OR = 11.39) 和经济原因 (OR = 6.02) 与胰岛素依从性独立相关。在 14.4% 的受试者中发现饮食行为紊乱，其中大多数属于不依从组。结论：只有 50% 的 1 型糖尿病患者有依从性。与不依从相关的主要因素是经济原因和对低血糖的恐惧。