Insulin Refusal Among Type-2 Diabetics: Healthcare Provider’s Perspective

Benazir Shafqat, Bakhtawar Abbasi, Sabeeh Akbar


Objective: Aim of this study is to determine frequency of patients with type-2 diabetes mellitus who refuse to take insulin therapy

Design & duration: This is a cross sectional study completed in six months duration.

Setting: Study was conducted in medical out-patient door of Bahawal Victoria Hospital Bahawalpur.

Patients & methods: Patients presenting to out-patient door of medical department having type-2 diabetes taking oral anti diabetics and having poor glycemic control. When these patients were advised to take insulin therapy their response was documented on a performa. Who refused they were asked about its reason and their perspective which was noted down. Consent was taken from all cases in study group. Permission was taken from ethical committee of the institution. Patients of either sex and of any age were included in the study. Confidence level. Confidence interval was 95% with 5% margin of error.

Results: Total 200 cases were studied including 62% female and 38% male patients. When these patients were advised to take insulin therapy, 5.5% agreed while 94.5% refused. Main cause of refusal was fear of injection pain in 41.3% cases and fear of addiction was in 27% cases. Mean age of patients was 40.3±8.5 years. 

Conclusion:  Majority of type-2 diabetic people on oral antidiabetics have fear to use insulin therapy. Injection site pain or fear of addition are main causes of refusal


Diabetes mellitus type-2, Insulin, Glycemic control

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Mudassar Hussain, Syed Baqir Shyum Naqvi, Maqsood Ahmed Khan, Syed Monis Jawed, Muhammad Akram. Perception and attitude of insulin usage in Diabetes mellitus type 2 patients in Pakistan: A questionnaire based study. World J Pharm Sci. 2015; 3(3): 605-608.

International Diabetes Federation Guideline. 2005.

Goldstein BJ, et al. The global partnership for effective diabetes Management, type2 diabetes treats early, treatment intensively. Int J Diab Clin Pract. 2007; 61: 16–21.

National Institute of Diabetes and Digestive and Kidney Diseases, National Diabetes Statistics Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2005

Wright A, et al. U.K. Prospective Diabetes Study Group. Sulfonylurea inadequacy: efficacy of addition of insulin over 6 years in patients with type 2 diabetes in the U.K. Prospective Diabetes Study (UKPDS 57). Diabetes Care. 2002; 25(2):330–6

Wei Leong Tan, Siti Fairus Asahar, Noor Liani Harun. Insulin therapy refusal among type II diabetes mellitus patients in Kubang Pasu district, Kedah, Malaysia. Singapore Med J. 2015; 56(4): 224-227.

Naomi S Levitt. Barriers to initiating insulin therapy in patients with type 2 diabetes mellitus in public-sector primary health care centers in Cape Town.

David Haslam. Should we Fear Insulin Therapy in the Treatment of Type 2 Diabetes? The Open Obesity Journal, 2014, 6, 70-75.

Paul Dromgoole. Supporting people with diabetes to engage with insulin therapy. Journal of Diabetes Nursing 20154 Volume 18 No 9.

Anil Kapur. Economic analysis of diabetes care. The Indian Journal of Medical Research. 2007, 125(3):473-82.


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