Messele, Bruck (PhD)Reshid, Elham2018-10-232023-11-062018-10-232023-11-062017-07http://etd.aau.edu.et/handle/123456789/13076Prevalence of Delayed initiation of insulin and its associated factors among patients with type 2 diabetes at the diabetes clinic of Tikur Anbessa Specialized Hospital. Elham Reshid, Addis Ababa University, 2017 Introduction: Type 2 diabetes mellitus prevalence is much more common than type 1 diabetes where metformin remains to be the first line medication. However, it is recommended to initiate insulin when oral therapy fails which is inconsistent due to different factors to result in delay. Failure to achieve glycemic control due to delayed insulin initiation result in different complications. Both the prevalence and associated factors need to be studied to avoid complications. There is no such study conducted in the current setting as well. Objectives: The aim of the study was to assess the prevalence of delayed insulin initiation among patients with type 2 diabetes being managed in the Diabetes Clinic of Tikur Anbessa Specialized Hospital and explore the associated factors. Methods: Both quantitative and qualitative data were collected from January 1, 2017 to March 30, 2017 G.C. using data abstraction form and a semi structured interview guide, respectively. For the quantitative part, data entry and analysis was held using Epi Info and SPSS version 20 software‟s, respectively. Thematic analysis was used for the qualitative finding. Result: The prevalence of delayed initiation of insulin in patients with type 2 diabetes mellitus at the diabetes clinic was found to be 64.2%. Contributing factors were identified. Patient factors included beliefs about the necessity of insulin and concerns related to starting insulin. Physician factors included perceived patient‟s situation regarding anticipated side effects and other patient factors and lack of clinical competency. Health institution factors included inadequate laboratory set up and absence of contextual guidelines for diabetes management including insulin initiation. Conclusion and recommendations: The prevalence of delayed insulin initiation was found to be 64.2% and factors included patient, physician, and health institution. Solutions included strengthening the diabetes health education program and focusing on task shifting.en-USDelay in insulin initiation, Ethiopia, Tikur Anbessa Specialized Hospital, Type 2 Diabetes MellitusThesis