Who Is At Fault?

I dislike preaching on a topic; however, this is one topic that I admit galls me and I have to wonder why is it that our doctors are afraid to prescribe insulin except as a medication of last resort. I have always wondered if they were not confident with prescribing insulin because they did not know enough about it to teach the patients how to use it, or if they believe some of the myths about diabetes. With the findings of this study (link is now broken), I may have to eat a little crow.

“In a current study it was found that there are certain barriers for physicians that prevent them prescribing insulin much earlier in the treatment of diabetes.... .“ The barriers are often the patients themselves. The people with type 2 diabetes are so ingrained in the myths of insulin that the patients become the barriers to improved health.

Not having been exposed to the insulin myths until several years after being on insulin has been an advantage for me. It seems that many type 2 patients really believe this gobbledygook and refuse to let their doctors prescribe insulin for them or take the prescription and do not use it. Read my blog here about the insulin myths as it shows the below reasons and needs widespread reading.

The study found that 35% of the patients believed insulin causes blindness, renal failure, amputations, heart attacks, strokes, or early death. “From the results it was concluded that among poorly controlled patients with Type 2 diabetes newly prescribed insulin, the major predictors of insulin nonadherence included plans to improve health behaviors in lieu of starting insulin, negative impact on social and work life, injection phobia, and concerns about side effects or hypoglycemia.”

While the study found these legitimate concerns, they are myths, which the doctors need to correct. Adding more oral medications does not seem to bring about improvement in blood glucose levels. Many studies have shown more oral medications can have unhealthy effects and increase the risk of cardiovascular events.

“Not previously reported is the finding that nonadherent patients frequently felt their provider had not adequately explained the risks and benefits of insulin.” This statement saves me from having to eat too much crow. There is a lot of work that need to be done on both sides – physician and patient, to educate everyone concerned about the use and benefits of insulin.