| Abstract: |
This article explores some of the barriers to the initiation of insulin therapy in patients with type 2 diabetes, noting that new recommendations for these patients call for more rapid use of both oral medications and insulin therapy. Although most health care providers agree that insulin is an effective therapy for the management of type 2 diabetes, many still consider insulin therapy as the last resort and indicate that their patients are hesitant to take insulin. The author of this article recommends physicians first assess the patient‘s perspective regarding insulin therapy; many barriers can be identified from this discussion. The author briefly discusses some of these barriers, which include beliefs that the insulin use demonstrates personal failure, insulin is not effective, insulin injections are painful, insulin causes complications or death, fear of hypoglycemia, insulin causes weight gain, and insulin use will have a negative impact on lifestyle. The next section considers provider-identified barriers to insulin therapy and how to address each of them. These suggestions include referring patients for diabetes self-management education and medical nutrition therapy (MNT), providing ongoing self-management support, using strategies already proven successful, and addressing emotional issues. 4 references. |