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Patients reluctant to go on to insulin

In addition to the updated NICE guidelines for the management of type 2 diabetes is the need for people "with a higher HbA1c" to be informed that any reduction in HbA1c towards their agreed target is advantageous to future health.

The United Kingdom Prospective Diabetes Study (UKPDS) of patients on either insulin or an oral therapy, shows that every 1% drop in HbA1c reduces a patient's risk of heart attack by 14% and the risk of blindness by 37%. However, patient awareness of these figures is worryingly low, with only 7% correctly identifying the reduction in risk of heart attacks and 10% the reduction in risk of blindness.

The survey also reveals that 85% of GPs believe that patients' reluctance to go on to insulin hampers GPs' ability to reduce HbA1c to target levels, leaving patients at an unnecessary, increased risk of complications.

Furthermore, 94% of patients who take insulin believe that it would have been useful to receive information on insulin earlier in their treatment. GPs also believe that patients need to be educated further about the benefits of insulin, with 88% agreeing with the need for more information. NICE guidelines prioritise structured education for every person with diabetes and/or their carer at and around the time of diagnosis and with reinforcement and review on an annual basis.

Adrian Sanders, Chair of All Party Parliamentary Group on Diabetes (APPGD), said: "These survey results clearly show that patient barriers to insulin need to be broken down by earlier, ongoing education about the role it has to play in helping them achieve blood glucose targets. Only this way will effective treatments be welcomed by patients at the appropriate stages of therapy and their risk of developing complications minimised."