Dr. Prasad Potdukhe, Dr. Pranay Gandhi


Introduction: Diabetic patients being on rise, a significant amount of patients now need insulin to manage their blood sugars and hence aim of this study was to study the barriers in starting insulin to patients with diabetes.
Methods: This hospital based descriptive observational study was conducted on 104 patients of diabetes in the department of general medicine in a tertiary hospital in central India. Participants were randomly selected, and then they completed the insulin noncompliance questionnaire (20 questions). Results: Out of the total 292 patients studied, the most common reason for insulin refusal was fear of needles (64.7%) followed by belief in alternate medicine for insulin control (20%), followed by requiring someone else to administer the injection (19.2%), cost (18.7%).
Conclusion: In India due to widespread propaganda of alternate medicine, the trust of patients in modern medicine has decreased. Therefore, targetted educational interventions can help minimize these problems and improve patients’ outcomes.


diabetic, insulin

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World Health Organization, Global Report on Diabetes. Geneva, 2016. Accessed 30 August 2016.

"Simple treatment to curb diabetes". January 20, 2014. Archived from the original on 2014-02-02.

Wild S, Roglic G, Green A, Sicree R, King H (2004). "Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030". Diabetes Care. 27 (5): 1047–53. doi:10.2337/diacare.27.5.1047. PMID 15111519

Williams textbook of endocrinology (12th ed.). Philadelphia: Elsevier/Saunders. pp. 1371–1435. ISBN 978-1-4377-0324-5.

Australian Indigenous HealthInfoNet, Chronic conditions: Diabetes. Accessed 31 August 2016.

Booya F, Bandarian F, Larijani B, Pajouhi M, Nooraei M, Lotfi J. Potential risk factors for diabetic neuropathy: a case control study. BMC Neurol. 2005;5(1):24. doi:10.1186/1471-2377-5-24

Ghanbari A, Yekta ZP, Roushan ZA, Lakeh NM. Assessment of factors affecting quality of life in diabetic patients in Iran. Public Health Nurs. 2005;22(4):311–322. doi:10.1111/j.0737-1209.2005.220406.x

Rossetti P, Porcellati F, Bolli GB, Fanelli CG. Prevention of hypoglycemia while achieving good glycemic control in type 1 diabetes: the role of insulin analogs. Diabetes Care. 2008;31(Supplement 2):S113–S20. doi:10.2337/dc08-s227

Mostafavian Z, Ghareh S, Torabian F, Yazdi MS, Khazaei MR. Data on insulin therapy refusal among type II diabetes mellitus patients in Mashhad, Iran. Data Brief. 2018;18:2047–2050. doi:10.1016/j.dib.2018.04.136

Mirahmadizadeh A, Delam H, Seif M, Banihashemi SA, Tabatabaee H. Factors Affecting Insulin Compliance in Patients with Type 2 Diabetes in South Iran, 2017: We Are Faced with Insulin Phobia. Iran J Med Sci. 2019;44 (312):1–10.

Habibi R, Soltani M, Habibi G. Factors affecting rejection by diabetics for insulin therapy. Iran J Diabetes and Lipid Disorders. 2012;11(4):366–376.

Goyal A, Kumar A. Effect of a diabetes education camp on perception of insulin therapy in patients of type-2 diabetes mellitus. Med J DY Patil Vidyapeeth. 2018;11(2):137.

Farsaei S, Radfar M, Heydari Z, Abbasi F, Qorbani M. Insulin adherence in patients with diabetes: risk factors for injection omission. Prim Care Diabetes. 2014;8(4):338–345. doi:10.1016/j.pcd.2014.03.001

Almaghaslah D, Abdelrhman AK, AL-Masdaf SK, Mohammed L, Majrashi BMM, Asiri WM, et al. Factors contributing to non-adherence to insulin therapy among type 1 and type2 diabetes mellitus patients in Asser region, Saudi Arabia. Biomedical Research. 2018;29(10): 2090–95.

Chen -C-C, Chang M-P, Hsieh M-H, Huang C-Y, Liao L-N, Li T-C. Evaluation of perception of insulin therapy among Chinese patients with type 2 diabetes mellitus. Diabetes Metab. 2011;37(5):389–394. doi:10.1016/j.diabet.2010.12.008

Jha S, Panda M, Kumar S, et al. Psychological insulin resistance in patients with type 2 diabetes. J Assoc Physicians India. 2015;63(7):33–39.

Ghadiri-Anari A, Fazaelipoor Z, Mohammadi SM. Insulin refusal in Iranian patients with poorly controlled type 2 diabetes mellitus. Acta Med Iran. 2013;51(8):567–571.

Peyrot M, Rubin RR, Kruger DF, Travis LB. Correlates of insulin injection omission. Diabetes Care. 2010;33(2):240–245. doi:10.2337/dc09-1348

Brod M, Pohlman B, Kongsø JH. Insulin administration and the impacts of forgetting a dose. Patient-Patient-Centered Outcomes Res. 2014;7(1):63–71. doi:10.1007/s40271-013-0029-9

Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Factors associated with psychological insulin resistance in individuals with type 2 diabetes. Diabetes Care. 2010;33:1747–1749. doi:10.2337/dc10-0099

Simmons JH, McFann KK, Brown AC, et al. Reliability of the diabetes fear of injecting and self-testing questionnaire in pediatric patients with type 1 diabetes. Diabetes Care. 2007;30(4):987–988. doi:10.2337/dc06-1553

Polinski JM, Smith BF, Curtis BH, et al. Barriers to insulin progression among patients with type 2 diabetes: a systematic review. Diabetes Educ. 2013;39(1):53–65. doi:10.1177/0145721712467696

Aikens JE, Piette JD. Diabetic patients’ medication underuse, illness outcomes, and beliefs about antihyperglycemic and antihypertensive treatments. Diabetes Care. 2009;32(1):19–24. doi:10.2337/dc08-1533


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