AADE Survey: Taking Insulin Is a Hardship on Many—and They’re Reluctant to Talk About It With Caregivers

More than 29 percent of the people surveyed feel that injecting insulin is the hardest aspect of their diabetes care.

Aug 15, 2008

Results from a Harris survey commissioned by the American Association of Diabetes Educators (AADE) show that people with diabetes who must take insulin often struggle with dread and negative impacts on their lives because of it. But more than half of them—52 percent—are reluctant to share their concerns with their healthcare providers.

The “Injection Impact Report” survey, which was conducted online between June 12 and July 7, surveyed 502 people with diabetes who inject insulin using either a syringe or a pen. The survey also queried healthcare professionals who treat people with diabetes who inject insulin, including 101 primary care physicians (PCPs), 100 endocrinologists, and 100 diabetes educators.

Among the findings:

  • 33 percent of respondents have experienced some level of dread related to insulin injections (eight percent strongly agreed/and 25 percent somewhat agreed)
  • 14 percent of those surveyed feel that insulin injections have a negative impact on their life (three percent experience a major negative impact and 11 percent experience a moderate negative impact)
  • More than 29 percent of the people surveyed feel that injecting insulin is the hardest aspect of their diabetes care (eight percent strongly agreed and 21 percent somewhat agreed).
  • 52 percent do not proactively discuss their concerns regarding the physical and emotional aspects of injecting with their healthcare provider.

Thirty-seven percent of the respondents with diabetes felt that discussing their concerns about insulin would be a bother to their healthcare providers. However, says the AADE, the survey of healthcare professionals, which included PCPs, endocrinologists, and diabetes educators, told a different story: Seventy-one percent said they are aware of the impact that insulin injections have on their patients' quality of life, and 40 percent have initiated a dialogue in the past with their patients about these issues.

“When developing the survey, we had two goals in mind,” said Amparo Gonzalez, RN, BSN, CDE, president of the AADE. “The first was to encourage patients to take a more proactive role in communicating with their healthcare team about their concerns regarding insulin injections. The second was to dispel the myth that healthcare providers were unaware of or were unwilling to address the quality of life issues surrounding insulin injections.”

“I am not surprised that many people with diabetes are not talking with the doctors or diabetes educators about their injections,” said Debra Lofton, a member of the Injection Impact Report Discussion Group that the AADE created in response to the survey. Lofton takes insulin injections for her diabetes.

“For years I skipped meals or injections to avoid the hassle and discomfort of taking them, but when it came to talking with my doctor about it, I did not speak up as much as I could have. When I did finally talk to my diabetes educator about my injections, I learned there were other, less painful ways to manage my diabetes effectively. I am so happy I finally said something.”

The AADE has more information in the Injection Impact Report online.

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Categories: Case Studies, Diabetes, Diabetes, Doctors & Nurses, Health Care, Insulin, Lancing Devices, Psychology, Syringes, Type 1 Issues, Type 2 Issues

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Posted by Anonymous on 14 August 2008

As a type I diabetic of nearly 43 years, I've always told my friends that taking injections is the easy part, per se. Until I was back on an insulin pump, it was a nuisance to have to take five shots a day; but compared to the constant juggling of insulin dosages, exercise, food intake and work-related stress levels that is necessary to maintain good sugar levels, taking shots is nothing. If only that were all I had to do!

Posted by Anonymous on 15 August 2008

I'm a type 1 diabetic of 31 years (since age 17).

I have been on an insulin pump for 15 years. It's not perfect but gives me much better control. I feel the easiest part is the distribution of insulin whether by injection or pump. The worst? Hands down ... the overall control and daily routine of such. It gets tiring! In addition, I worry about the impact of the disease long term. You don't have full confidence in your health and control of the disease esp. due to stress and other details of life that may rattle the blood sugar/A1C numbers. I do my best maintaining good control and keep a close eye on my diet, exercise and health care needs.

Posted by Anonymous on 15 August 2008

Having had Type i diabetes for 55 years, taking insulin injections has never been a problem for me - except for the first few months.

Before I began pump use, I took sometimes
10 injections a day - this allowed me to lead a very normal life, eating a fairly normal food regimen. I must say that using a pump makes life MUCH easier, but I never had any problems with taking injections.

Posted by Anonymous on 15 August 2008

Having Type 1 diabetes for 43 years and taking my insulin injections 4 times a day
is not a problem. When I was younger it was
once a day, about 8 years ago is when I started 4 a day. It's all in your attitude and look at life, I'm very grateful that I can control my Diabetes and am able to live
as normal as I am able. Keep a positive out look on life.
Gilbert, AZ

Posted by Fransgate on 15 August 2008

As a diabetes educator I find that physicians often "threaten" their patients with taking insulin, particularly people with long-standing Type 2. "If you don't follow your diet and do your exercises I will HAVE to put you on insulin. "You don't want that, do you?" I find that behavior on the part of physicians creates anxiety about taking insulin and also about being a "bad" patient.

Posted by wifey on 15 August 2008

My husband also denied insulin for seven years. He thought he would go into insulin shock while he was working alone on his boat and die. Actually, when he finally started using insulin (a matter of life or death) he discovered that he can tell before he takes his blood sugar test, whether he is high or low. He's one of the fortunates whose body signals the approximate state of his sugar level. We have, in the bedroom, an electric alarm clock with red digital figures. If he wakes in the night and they're blurry, he knows he's low.
He wishes he'd tried the insulin long before he actually came round to using it.

Posted by Anonymous on 16 August 2008

I have run into some doctors that throw up "lap ban" or "stomach by-pass surgery" at me. I don't want either I have been type 2 for 11 years and 4 years ago I finally agreed to use insulin. I do find it hard to discuss insulin use with a doctor because I have a concern that the talk of surgery will arise again.

Posted by Anonymous on 24 August 2008

I have had type 2 diabetes for over seven years, when first diagnosed I was prescribed only metformin. I immediately went on a diet and exercise regime for six months resulting results that encouraged my doctor (at that time) to suggest if kept up the regime within a year or so I would probably be off medication. Well, I couldn't keep it up and now nearly seven years later my current doctor has been suggesting insulin as a treatment. My fasting levels remain around 140 mg/dl and I should lose approx. 60 lbs but I have a severe aversion to injections, I am just not ready to take insulin and am in a quandary.

Posted by Anonymous on 1 September 2008

I've read here that I'm not the only one with an aversion to insulin. I've been on glucophage, actos, and glimipiridie for 10 years with good a1c (under 6.6), but with recent weight gain I just registered 7.4. I'm seeing my dr. this week and am scared to death that he is going to insist on insulin. I can't see myself doing injections although I do it to my cat. I am going to get help with an exercise program because that's what I need; diet is not the problem. I wonder if your physician can deny oral meds and inisist on insulin?

Posted by Anonymous on 4 September 2008

This was a surprisingly poorly-designed study, and one which I would add does not even ASK what type of diabetes a person has. On top of that, it investigates apprehension without asking what is behind that apprehension. We should expect better from the AADE.

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