title: Correlates of insulin injection omission.
abstract: OBJECTIVE
  The purpose of this study was to assess factors associated with patient frequency of intentionally skipping insulin injections.
  
  
  METHODS
  Data were obtained through an Internet survey of 502 U.S. adults self-identified as taking insulin by injection to treat type 1 or type 2 diabetes. Multiple regression analysis assessed independent associations of various demographic, disease, and injection-specific factors with insulin omission.
  
  
  RESULTS
  Intentional insulin omission was reported by more than half of respondents; regular omission was reported by 20%. Significant independent risk factors for insulin omission were younger age, lower income and higher education, type 2 diabetes, not following a healthy diet, taking more daily injections, interference of injections with daily activities, and injection pain and embarrassment. Risk factors differed between type 1 and type 2 diabetic patients, with diet nonadherence more prominent in type 1 diabetes and age, education, income, pain, and embarrassment more prominent in type 2 diabetes.
  
  
  CONCLUSIONS
  Whereas most patients did not report regular intentional omission of insulin injections, a substantial number did. Our findings suggest that it is important to identify patients who intentionally omit insulin and be aware of the potential risk factors identified here. For patients who report injection-related problems (interference with daily activities, injection pain, and embarrassment), providers should consider recommending strategies and tools for addressing these problems to increase adherence to prescribed insulin regimens. This could improve clinical outcomes.
authors.affiliation: Department of Sociology, Loyola University Maryland, Baltimore, Maryland, USA. mpeyrot@loyola.edu
authors.forename: Mark
authors.initials: M
authors.lastname: Peyrot
authors.forename: Richard R
authors.initials: RR
authors.lastname: Rubin
authors.forename: Davida F
authors.initials: DF
authors.lastname: Kruger
authors.forename: Luther B
authors.initials: LB
authors.lastname: Travis
mesh_terms: D000328:Adult; D000368:Aged; D001519:Behavior; D002318:Cardiovascular Diseases / Q000150:complications; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology; D003925:Diabetic Angiopathies / Q000188:drug therapy; D005006:Ethnicity; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007182:Income; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010465:Perception; D044469:Racial Groups; D012044:Regression Analysis; D012309:Risk-Taking; D012648:Self Care / Q000592:standards
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin