Barriers to insulin initiation and intensification and how to overcome them.
OBJECTIVE
To review published evidence and clinical experience of the perceived barriers to insulin initiation and intensification and to develop solutions for patient management.


METHODS
Literature review and workshop discussions.


RESULTS
Many patients with diabetes fail to achieve targets for glycaemic control because of inappropriate use of insulin. Patients and health care professionals face many potential barriers to insulin initiation and intensification in primary care. These can be categorised as low motivation, lack of familiarity or experience and time constraints.


CONCLUSIONS
Solutions should be tailored to different health care settings. Strategies include improving education and training, providing prescribing aids and increasing the efficiency of collaborative working and communications.
Kunt
T
T
Medical Clinic, Johannes-Gutenberg-University, Mainz, Germany. thomaskunt@gmail.com
Snoek
F J
FJ
D001291:Attitude of Health Personnel; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology; D005194:Family Practice; D005239:Fear; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D013997:Time Factors; D016526:Workload
D007004:Hypoglycemic Agents; D007328:Insulin