2002
DOI: 10.1038/sj.ijo.0802173
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Abstract: Insulin therapy has proven benefits in Type 2 diabetes patients when combination therapy has failed. However, there is some reluctance by both patients and healthcare professionals to initiate insulin therapy. This reluctance has been termed 'psychological insulin resistance'. Barriers to the initiation of insulin therapy include patients' fear of disease progression and needle anxiety; mutual concerns about hypoglycaemia and weight gain; and health professionals' use of insulin as a threat to encourage compli… Show more

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Cited by 374 publications
(278 citation statements)
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“…More specifically, concerns about hypoglycemia risk and weight gain (8,9) often delay insulin initiation for many years, and gastrointestinal adverse events (GI AEs) such as nausea and vomiting make GLP-1 RA intolerable for some patients, prompting low adherence and frequent drug discontinuation (10).…”
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confidence: 99%
“…More specifically, concerns about hypoglycemia risk and weight gain (8,9) often delay insulin initiation for many years, and gastrointestinal adverse events (GI AEs) such as nausea and vomiting make GLP-1 RA intolerable for some patients, prompting low adherence and frequent drug discontinuation (10).…”
mentioning
confidence: 99%
“…[6][7][8][9] Recent work has focused on documenting delays in initiating insulin or intensifying oral therapy, 8,9 and exploring patient and physician barriers to insulin initiation. [10][11][12] Very little is known about patterns of treatment intensification among individual patients once insulin is initiated. Limited data from studies conducted in the United Kingdom and by Kaiser Permanente Northwest suggest that 75-90 % of patients are persistent with insulin, dose increases are far more common than changes in medications, and glycemic control remains suboptimal.…”
mentioning
confidence: 99%
“…However, there are barriers to initiating insulin [2,3], including fear of hypoglycemia, fear of multiple injections, and weight gain. The new generation of insulin analogs enables many of these barriers to be overcome but the best method of initiating insulin remains a subject of debate.…”
Section: Introductionmentioning
confidence: 99%