title: Initiating insulin as part of the Treating To Target in Type 2 Diabetes (4-T) trial: an interview study of patients' and health professionals' experiences.
abstract: OBJECTIVE
  To explore patients' and health professionals' experiences of initiating insulin as part of the Treating To Target in Type 2 Diabetes (4-T) randomized controlled trial.
  
  
  METHODS
  Interviews were conducted with 45 trial participants and 21 health professionals and thematically analyzed.
  
  
  RESULTS
  Patients were generally psychologically insulin receptive when approached to participate in the 4-T trial. Their receptiveness arose largely from their personal experiences observing intensifying prior treatments and deteriorating blood glucose control over time, which led them to engage with and accept the idea that their diabetes was progressive. Health professionals also fostered receptiveness by drawing on their clinical experience to manage patients' anxieties about initiating insulin.
  
  
  CONCLUSIONS
  Previous studies may have overemphasized the problem of psychological insulin resistance and overlooked factors and treatment experiences that may promote insulin receptiveness among type 2 patients.
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK. n.e.jenkins@ed.ac.uk
authors.forename: Nicholas
authors.initials: N
authors.lastname: Jenkins
authors.forename: Nina
authors.initials: N
authors.lastname: Hallowell
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Farmer
authors.forename: Rury R
authors.initials: RR
authors.lastname: Holman
authors.forename: Julia
authors.initials: J
authors.lastname: Lawton
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin