ArticleEuropean endocrinology2020
Prevalence of Primary Non-adherence with Insulin and Barriers to Insulin Initiation in Patients with Type 2 Diabetes Mellitus - An Exploratory Study in a Tertiary Care Teaching Public Hospital.
Article in European endocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 21 citations in OpenAlex.
- Medication Adherence and its Predictors in Patients With Type 2 Diabetes Mellitus in India: A Systematic Review and Meta-Analysis of Current Evidence.Health science reports · 2026Review
- Evaluating the Effectiveness of Insulin Plus Oral Medications Versus Oral Anti-Diabetes Therapy Alone in Patients With Newly Diagnosed Type 2 Diabetes With Very High hbA1c and Acute Coronary Syndrome.Endocrinology, diabetes & metabolism · 2025Observational
- "It is not a disease like cancer, we can live well with diabetes" - A qualitative study exploring positive experiences of diabetic patients.Journal of family medicine and primary care · 2025Article
- Determinants of adherence to obesity medication: A narrative review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025Review
- Prevalence, causes, impacts, and management of needle phobia: An international survey of a general adult population.PloS one · 2022Article
- Evolving Concepts of Type 2 Diabetes Management.The Medical clinics of North America · 2021Review
- The prevalence and evidence-based management of needle fear in adults with chronic disease: A scoping review.PloS one · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThere is a paucity of data analysing the reasons for primary non-adherence following first prescription of insulin among patients with uncontrolled type 2 diabetes mellitus (T2DM) in India. To address this, and to attempt to understand these reasons, an exploratory study was undertaken to assess the prevalence of primary non-adherence with insulin and barriers to insulin initiation in these patients.
methodsStudy participants were randomly selected from patients with T2DM who visited the diabetes clinic of a tertiary care teaching public hospital in Rishikesh, Uttarakhand, India, and were prescribed insulin for the first time in last 2-year period. All participants were evaluated for history of primary non-adherence, and those who were non-adherent were subsequently interviewed face-to-face using a modified, validated semi-structured questionnaire to identify the reasons for primary non-adherence. A focused group discussion was also conducted with eight physicians to elicit their views about reasons for primary non-adherence with insulin.
resultsA total of 225 patients were identified and interviewed; of these, 105 were identified with a history of primary non-adherence and underwent a subsequent face-to-face interview. There was a high prevalence of primary non-adherence with insulin among the participants of this study. The main reasons for non-adherence were low self-efficacy, doubt about clinical benefits of insulin, fear of hypoglycaemia, needle phobia, unaffordability of insulin and blood glucose monitoring device, strong faith in alternative medicines and mythical ideologies, and fears of insulin being addictive and that it may cause rapid aging.
conclusionWith the high prevalence of primary non-adherence, and the multitude of reasons for this, it is clear that we need to eliminate these barriers to treatment. Thus, provision of dedicated diabetes educators in each diabetes clinic and availability of cost-effective insulin and blood glucose monitoring devices for the underprivileged population are key to achieve this.
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