title: Attitudes of patients and physicians to insulin therapy in Japan: an analysis of the Global Attitude of Patients and Physicians in Insulin Therapy study.
abstract: BACKGROUND
  The barriers to insulin therapy perceived by Japanese patients with diabetes and their physicians are unclear.
  
  
  METHODS
  We performed sub-analyses of the Global Attitude of Patients and Physicians in Insulin Therapy (GAPP™) study, which included 100 Japanese physicians (of 1250 participating physicians) and 150 Japanese patients (of 1530 patients) who participated in Internet surveys (physicians) or computer-assisted telephone surveys (patients) across eight countries in 2010. We compared the results of Japanese participants with those obtained for the other seven countries.
  
  
  RESULTS
  Overall, 44% of the Japanese patients reported omission or non-adherence to insulin, a greater value than that reported in other countries. Japanese physicians reported that non-adherence to insulin was driven by their patients' lifestyles. A greater proportion of patients had a history of hypoglycemia in Japan than in other countries. Most of the physicians (94%) and patients (84%) in Japan reported that the currently available insulin treatment regimens do not fit the diverse lifestyles of patients.
  
  
  CONCLUSIONS
  Many Japanese patients receiving insulin therapy omit or do not adhere to insulin, possibly because of fear of hypoglycemia, or for lifestyle reasons. Insulin regimens that reduce the risk of hypoglycemia without interfering with patients' lifestyles are needed.
authors.affiliation: a Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine , Kyoto University , Kyoto , Japan.
authors.forename: Shin-Ichi
authors.initials: SI
authors.lastname: Harashima
authors.affiliation: b Department of Human Health Sciences, Graduate School of Medicine , Kyoto University , Kyoto , Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishimura
authors.affiliation: a Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine , Kyoto University , Kyoto , Japan.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Inagaki
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D007328:Insulin / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D007328:Insulin
keywords: Insulin therapy; Japan; attitudes; hypoglycemia; lifestyle; perceptions