Campus Location

Dallas Campus (Online)

Date of Award


Document Type

DNP Project



Degree Name

Doctor of Nursing Practice

Committee Chair or Primary Advisor

Patricia Sunderhaus

Second Committee Member or Secondary Advisor

Zohreh Schuessler


Resistance to insulin therapy is primarily due to emotional and intellectual perceptions among patients with type 2 diabetes (T2D) new to insulin therapy. Providers’ effective approach to diabetes education equips patients with knowledge, which can reduce resistance to insulin therapy. This project included patients with T2D between the ages of 18 to 70 whose glycated hemoglobin (HgbA1c) was ≥ 8.5% taking two or more oral antidiabetic agents and not on insulin therapy. Data were collected using the Insulin Treatment Appraisal Scale (ITAS), a 20-item instrument that contains 16 negative and four positive statements that appraise an individual’s perception of insulin treatment. Each statement is rated using a 5-point Likert-type scale. Descriptive statistics were used to analyze collected ITAS data. A paired samples t test was conducted to compare the ITAS scores at pre- and postimplementation. The goal was to reduce the overall mean ITAS score, which would indicate a more positive appraisal of insulin. There was a statistically significant decline in ITAS scores from pre- to post-, t(44) = 1.99, p = .048. Clinical significance was also supported by the decline in ITAS scores, which indicate a more positive appraisal of insulin after the implementation. The reliability and internal consistency were conducted using Cronbach’s alpha, and the findings showed an α = .702 for the presurvey scores and α = .730 for postsurvey scores, which fall into the “good” reliability. The project manager recommended that providers engage with their patients and evaluate all barriers to insulin therapy. Keywords: type 2 diabetes, insulin therapy resistance, insulin reluctance, suboptimal glycemia

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



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