What is it about?

Although there is an increasing trend in adult diabetes, the most appropriate and cost saved treatment option---insulin therapy may not be completed accepted by the most Chinese population and society, for it may be misunderstaken as an addictive drug and stigma in some chinese people's expression. Other important reasons, such as lack of nurse follow-up, lack of training on insulin treatment , and effective communication also paved for the resistance to the initiation insulin treatment. A previous survey in Shanghai community showed that average of HbA1c, an indicator assessd for the diabetes control in past 120 days, was 8.5% at the time of initiation insulin treatment in Shanghai community. So, we analyzed factors related to the barriers in community doctor's perception on insulin treatment, before and after training , and results showed besides effective and chronic training , there is a need to change the perception of insulin in majority of Chinese people.

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Why is it important?

With an increase in diabetes incidence, the most effective treatment---insulin treatment was misunderstood as evil from traditional expression, associated with misunderstanding of the implication of this treatment, where the benefit of short-period intensive therapy and the insulin-dependent treatment were mixed up. So, this expression will delay the right time to prevent the higher onset of diabetic complications. No detection of glucose no diabetes may be a phenomenon of deceiving oneself. The psychological barriers, as well as confidence in community doctors for initiation of insulin therapy, should be addressed and receive massive support from not only the training with insulin skills but also change the perception of many Chinese people. The initiation of short-period intensive insulin treatment could be the most effective resolution of a higher incidence of current uncontrolled hyperglycemia and pancreas function impairment, as well as diabetes alleviation or prevention of incidents of acute complications. The training of skills on insulin also encompassed timing and follow-up.


There is a need for training in insulin skills for diabetes, not only on calculating and titrating dosage but also on its timing and increasing self-monitoring education (such as the best control level for different populations) in community care institutes.

Dr. Song Wen
Shanghai Pudong Hospital

Read the Original

This page is a summary of: The Barriers to Insulin Therapy Initiation in Type 2 Diabetes Patients: A Study of General Practitioner Perceptions in Huinan Community in South Shanghai, Diabetes Metabolic Syndrome and Obesity, January 2024, Taylor & Francis,
DOI: 10.2147/dmso.s446349.
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