title: Challenges associated with insulin therapy in type 2 diabetes mellitus.
abstract: Despite advances in treatment for type 2 diabetes in recent decades, many patients are failing to achieve adequate glycemic control. Poor glycemic control has been shown to have a detrimental effect on patients' health and well-being, and to have significant negative financial implications for both patients and healthcare systems. Insulin therapy has been proven to significantly reduce glycated hemoglobin levels; however, both patients and physicians can be reluctant to initiate insulin therapy. Research shows that both patient and provider factors contribute to a delay in initiation of insulin therapy. This review discusses the most common barriers contributing to this delay with potential solutions to overcome them.
authors.affiliation: Department of Endocrinology and Metabolism, VA San Diego Healthcare Center, San Diego, Calif. Electronic address: svedelman@vapop.ucsd.edu.
authors.forename: Steven
authors.initials: S
authors.lastname: Edelman
authors.affiliation: Department of Endocrinology, University of California, San Diego, Calif.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Pettus
mesh_terms: D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000523:psychology / Q000628:therapy; D019468:Disease Management; D016903:Drug Monitoring; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control / Q000523:psychology; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects; D007267:Injections / Q000379:methods / Q000523:psychology; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects; D055118:Medication Adherence / Q000523:psychology; D011788:Quality of Life; D018570:Risk Assessment
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Adherence; Barriers; Hypoglycemia; Insulin; Type 2 diabetes