Patient and Physician Barriers to Instituting Insulin Therapy: A Case-Based Overview

Charles F. Shaefer, Jr., MD, FCCP, FACP

INTRODUCTION

Diabetes is increasing in our adult and adolescent populations at an epidemic rate.¹ Microvascular and macrovascular complications frequently result from this disease. Many studies have shown that intensive treatment of diabetes with advancing therapy to include insulin can reduce the rate of diabetic complications.^2–4 Despite the promising outlook that can result from intensive therapy, many patients and physicians are reluctant to advance therapy, especially when it involves the addition of insulin.⁵