Barriers to Insulin Therapy Initiation by Adult Type 2 Diabetics at Family Health Centers in Sudan

Type Two Diabetes Mellitus is a progressive disease by nature so most patients will inevitably require insulin therapy to maintain adequate glycaemic control. Insulin use is delayed in many patients who would benefit from such treatment. Patient’s beliefs and perceptions regarding insulin therapy create barriers contributing to the delay in its initiation. Aimed to study the barriers to insulin initiation from a patient’s perspective, by performing a Cross-sectional study in the East Nile locality Khartoum; between February 2019 to May 2020. A questionnaire included demographic features, the status of insulin initiation, barriers to insulin initiation and knowledge about insulin therapy for Type 2 diabetes were administered during face-to-face interviews, which resulted in the majority of 307 participants being females aged 45 – 56, (57.7%) of them had HbA1c higher than 7. The commonest barrier to insulin use was found to be fear of hypoglycemia (72.0%), followed by insulin should be a final option and when started should not be stopped (64.5%) 60% thought that insulin leads to weight gain and (59.9%) of them had needle phobia. The conclusion is that Patients' concerns and beliefs regarding insulin use are multiple. a major factor behind diabetes patients' refusal of initiation of this therapy appears to be a lack of adequate information and misconceptions relating to insulin use, such as benefits and side effects.