Thirty per cent of people with type 2 diabetes do not begin insulin treatment when their doctors instruct them to, US researchers have said.
A study which involved nearly 3,300 people in the US showed three in 10 adults with type 2 diabetes delay insulin treatment for an average of two years.
“This matters to patients because insulin therapy is typically offered to patients with high blood sugar levels,” said senior study author Dr Alexander Turchi, from the Brigham and Women’s Hospital and Harvard Medical School in Boston.
“Many clinicians have encountered this phenomeno, but until our study it was not known just how prevalent delays in insulin initiation are. As physicians, we need to make sure that these patients are making fully informed decisions and that we understand their perspective to ensure they are treated effectively.”
During the trial, the researchers used a computer programme to look at data from 3,295 patients with type 2 diabetes between 2000-2014 to investigate how many people declined to take insulin when they were advised to.
A total of 984 of the cohort initially declined insulin. Among the 374 people who initially declined but ultimately started insulin, the mean time to insulin initiation was 790 days.
Of course, this wasn’t an experiment to prove how or whether delaying insulin impacted patients’ health, and the reasons for declining or delaying insulin were not revealed.
Insulin can be an effective medication for reducing blood glucose levels which can prevent complications of diabetes developing. However, insulin has side effects, particularly if taken in larger doses. The ideal situation is if the need to take insulin can be avoided, which is often possible through reducing carbohydrate intake.
Dr. Vanessa Arguello, an endocrinologist at the David Geffen School of Medicine at University of California, Los Angeles, who wasn’t involved in the study, said: “The key to avoiding insulin begins with making lifestyle changes early in the disease process – this can be as early as when people are diagnosed with prediabetes.
“It is immensely rewarding to see the positive effects from a carbohydrate-controlled diet, exercise, and weight loss on type 2 diabetes control – plus collectively it’s the most inexpensive option for optimal glucose control.”
The findings of the trial have been published in the Diabetic Medicine journal.

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