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Insulin adherence behaviours and barriers in the multinational Global Attitudes of Patients and Physicians in Insulin Therapy study
Open accessAbstract
AIMS: To examine patient and physician beliefs regarding insulin therapy and the degree to which patients adhere to their insulin regimens. METHODS: Internet survey of 1250 physicians (600 specialists, 650 primary care physicians) who treat patients with diabetes and telephone survey of 1530 insulin-treated patients (180 with Type 1 diabetes, 1350 with Type 2 diabetes) in China, France, Japan, Germany, Spain, Turkey, the UK or the USA. RESULTS: One third (33.2%) of patients reported insulin omission/non-adherence at least 1 day in the last month, with an average of 3.3 days. Three quarters (72.5%) of physicians report that their typical patient does not take their insulin as prescribed, with a mean of 4.3 days per month of basal insulin omission/non-adherence and 5.7 days per month of prandial insulin omission/non-adherence. Patients and providers indicated the same five most common reasons for insulin omission/non-adherence: too busy; travelling; skipped meals; stress/emotional problems; public embarrassment. Physicians reported low patient success at initiating insulin in a timely fashion and adjusting insulin doses. Most physicians report that many insulin-treated patients do not have adequate glucose control (87.6%) and that they would treat more aggressively if not for concern about hypoglycaemia (75.5%). Although a majority of patients (and physicians) regard insulin treatment as restrictive, more patients see insulin treatment as having positive than negative impacts on their lives. CONCLUSIONS: Glucose control is inadequate among insulin-treated patients, in part attributable to insulin omission/non-adherence and lack of dose adjustment. There is a need for insulin regimens that are less restrictive and burdensome with lower risk of hypoglycaemia.
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“As injection therapy is used by more than 80% of people with insulin-requiring diabetes, there is a clear need for intuitive, integrated systems to help multiple daily injection (MDI) patients interpret CGM data into actionable management steps to reduce the burden of demanding self-care directives and support telemedicine (3, 6, 10-13).”
From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“For people with insulin-requiring diabetes, dosing instructions may be complex and confusing (3-6).”
From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“As injection therapy is used by more than 80% of people with insulin-requiring diabetes, there is a clear need for intuitive, integrated systems to help multiple daily injection (MDI) patients interpret CGM data into actionable management steps to reduce the burden of demanding self-care directives and support telemedicine (3, 6, 10-13).”
From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [3]
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“Similar to all insulin analogues, the risk of hypoglycaemia is a major safety concern, and is considered a key obstacle in regulating blood glucose levels by both patients and physicians [10, 57].”
From A Review of the Pharmacological Properties of Insulin Degludec and Their Clinical Relevance (2014) · cites this paper as [10]
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Metadata
- Authors
- Peyrot, M., Barnett, A. H., Meneghini, L. F., & Schumm‐Draeger, P. ‐.
- Affiliations
- Johns Hopkins University (US)
- Heart of England NHS Foundation Trust (GB)
- University of Miami (US)
- München Klinik Bogenhausen (DE)
- Corresponding author
- Peyrot, M.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2012-04-16
- Volume
- 29
- Issue
- 5
- Pages
- 682-689
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- PMC
- PMC3433794
- OpenAlex
- W1613501644
- Cited by
- 655
- References
- 22
- Citations by year
- 2026: 29 · 2025: 41 · 2024: 61 · 2023: 43 · 2022: 42 · 2021: 43 · 2020: 53 · 2019: 49 · 2018: 52 · 2017: 48 · 2016: 52 · 2015: 50 · 2014: 46 · 2013: 35 · 2012: 8
- FWCI
- 38.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetic Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- insulin therapy, insulin adherence, insulin omission, barriers to adherence, patient beliefs, physician beliefs, type 1 diabetes, type 2 diabetes, glycemic control, hypoglycemia, basal insulin, prandial insulin, insulin dose adjustment
- MeSH terms
- Assessment of Medication Adherence, Blood Glucose, China, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, France, Germany, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Japan, Male, Middle Aged, Spain, Turkey, United States, Health Behavior, Drug Monitoring, Medication Adherence
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