More than one in three diabetes patients skip doses or fail to take their insulin as prescribed, according to new research.
Patients stated that they have done so on average three times in the last month, and 77% of physicians estimate that in reality the number of missed doses could be as high as six each month, according to the Global Attitudes of Patients and Physicians in Insulin Therapy (GAPPTM) survey, released today by Novo Nordisk.
The global survey, conducted in eight countries among almost 3,000 respondents, showed that 88% of physicians report that there are a significant proportion of patients still not reaching blood glucose targets, and four in 10 people with diabetes say they struggle to effectively control their blood sugar.
These results are in line with previous research which has shown that globally less than half of people with diabetes reach an optimal level of health and quality of life.
Professor Luigi Meneghini, Associate Director at the Diabetes Research Institute, University of Miami Miller School of Medicine, Florida, said, "The GAPPTM survey was designed to uncover the challenges patients and physicians are facing in obtaining effective outcomes in insulin therapy and it appears that busy lifestyles and difficulty in adhering to prescribed regimens are key contributing factors to poor glycaemic control.
"These results are consistent across countries and it is encouraging to see that physicians understand and empathise with the issues people with diabetes face."
Busy lives make it hard to comply with prescribed regimens
Change in normal routines, being too busy or simply forgetting to take the insulin are the main reasons cited by both patients and physicians for patients missing insulin doses or not taking it as prescribed.
More than half of physicians agree that their patients find it hard to comply with their regimens, particularly managing the number of injections and strict time constraints of some regimens.
These findings are supported by previous research which showed that fewer than one in five people with diabetes (19.4% of those with type 1 diabetes and 16.2% of those with type 2 diabetes) completely complied with all aspects of their prescribed regimens.
Your comments (terms and conditions apply):
"A doctor is there to guide the patients; however, there is a certain amount of blame that has to be assigned to the patient themselves. It's up to an individual to monitor their own health, and to track their experiences and then inform their doctor of any thing that is 'not right'. With the advancement of the internet, and the availability, there is no excuse to not self-monitor and do the research. I take my insulin injections and it a part of my life just like breathing, or talking. Self-govern, people, stop blaming others for your lack of conviction" - Debbie J, Canada
"Doctors are too busy to explain in full the consequences of not following an insulin regimen. They should encourage the patients to follow their prescribed insulin regimen as they will be able to achieve a much more healthy life in the future. One of the options, if available through the insurance, would be the insulin pump as it will allow a person to reach their goal and not be a 'slave' of the injections" - Esperanza, Florida
"There are multiple levels of barriers to adherence that must be dealt with beyond the patient's busy schedule. Topping the list is poor practitioner communication skills and lack of adequate reimbursement for spending time exploring patient barriers to adherence. Patient activation and adherence to prescribed treatment can be optimized by a participatory, patient-centered model of care that relies on a collaborative partnership between patient and practitioner where patient needs and input are listened to. This requires a transformational change in the way primary healthcare is delivered that is long overdue. One easy step to take in the right direction is to stop using the term 'compliance' which suggests a paternalistic 'you must do what I say' mentality. The term 'adherence' is much more appropriate and widely accepted among proponents of patient-centered care because it suggests the patient makes an active choice to follow recommended treatment" - Mary Beth Newman, USA
"Some of this could be remedied if we measured the level of health engagement of patients over time and communicated with them at the right engagement level. A simple measure such as the Bayer Conviction/Confidence scale is something that can be integrated into patient office visits on a quarterly/semi-annual basis and tracked over time. There is caregiver-patient interaction that targets the level of of
an individual's engagement can increase compliance and personal engagement over time. We need to track behavior change readiness and meet the patient at his/her readiness level to achieve positive change" - Joe Hodgson, US
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