Careful teamwork between diabetes and renal physicians and specialist nurses is highly desirable to achieve good glucose control in a group of patients at particular risk of microvascular and macrovascular complications.

The aim of this study was to determine if patients with insulin treated diabetes report problems with injecting insulin and self-monitoring of blood glucose (SMBG) in front of others and, if so, explore reasons for the problem.Seventy-six randomly selected patients completed a questionnaire. Statements were presented as 'Are you comfortable with injecting insulin/doing a blood glucose test in front of partner/own children/family/friends/work colleagues or in a public place?', and scored as: almost always/most of the time/sometimes/almost never.Forty-nine participants reported problems with injecting insulin and performing SMBG in the presence of others. Their characteristics were: 25 male and 24 female, 29 type 1 and 20 types 2 diabetes, age range 26-77 years (mean 50.8±12.9 years), duration of diabetes range 1-50 years (mean 19.6±12.8 years), and HbA1c range 6.0-11.5% (mean 8.14±1.25%). Just over a third of respondents 'almost never' felt comfortable with performing insulin injections and SMBG in a public place. Fifty percent of respondents 'almost never' inject insulin in front of work colleagues. Most respondents felt comfortable with performing insulin injections and SMBG in front of their partner, children and family.In conclusion, patients across all ages, gender, diabetes type and diabetes duration report problems with injecting insulin and performing SMBG in front of others. The most common reason cited was 'worried about upsetting or offending others'. Other reasons were 'worried about what others may think of you', and 'do not want others to know that you have diabetes'. A public awareness campaign may help overcome some of these barriers. Copyright

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