Attitude and Compliance with the Onset of Insulin Therapy in Patients with Type 2 Diabetes

Background: Insulin therapy refusal among type 2 diabetic patients is most challenging for healthcare providers. Objectives: This study aimed to evaluate the type 2 diabetic patients’ attitude and compliance with the initiation of insulin therapy. Methods: A cross-sectional study was conducted on 100 type 2 diabetic patients at the Endocrinology Clinic of Loghman Hakim Hospital, Tehran, Iran. A questionnaire was prepared to assess the attitudes toward the onset of insulin therapy. Positive and negative attitudes toward insulin injection were compared between the two groups of accepting and rejecting insulin therapy. Results: In this study, 62% of patients with type 2 diabetes tended to start insulin therapy. There was a statistical difference between the total positive and negative attitude items toward insulin therapy (agree/disagree) and acceptance of insulin therapy (P < 0.05). The most agreements related to a positive attitude in the two groups of accepting and rejecting insulin therapy belonged to statements “Insulin injection prevents complications of diabetes (micro and macrovascular)” as 100% (P < 0.001) and “Insulin injection helps improve my diabetes” as 96.8% (P < 0.001). The most agreements related to negative attitudes in the two groups of accepting and rejecting insulin therapy belonged to statements “Insulin injection causes my dependence on it” as 72.6% (P = 0.001) and “I can control my diabetes with oral medication and diet without insulin injection” as 97.4% (P < 0.001). Conclusions: As 38% of patients with type 2 diabetes refused to initiate insulin therapy, it seems that effective communication between physicians and patients and continuous follow-ups by health care providers can increase positive attitudes toward insulin injection.