Skipping Insulin

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Here at Diabetes Flashpoints, we have occasionally covered situations in which a conflict arises between saving money and following the instructions of a health-care provider. Topics in this vein include reusing lancets and syringes, sharing reusable medical devices, and abandoning drugs at the pharmacy because of cost. We’ve also mentioned how to talk to your doctor about cost-related concerns. But as the results of a survey on skipping insulin doses show, cost isn’t the only factor in whether someone with diabetes disregards certain medical advice or part of a treatment plan.

A recent article on the Web site highlights the results of the survey, published last year in the journal Diabetes Care. The online survey was taken by 502 adults living in the United States who took insulin injections for either Type 1 or Type 2 diabetes. Questions focused on insulin-taking habits as well as background information including age, income, education, and dietary habits.

Overall, more than half of respondents reported having intentionally skipped an insulin dose; 20% reported skipping doses regularly. Background factors associated with skipping insulin included younger age, lower income, higher education, having Type 2 diabetes (rather than Type 1), poorer dietary habits, having more injections to take each day, and reporting that injections caused pain or embarrassment or interfered with daily activities. Among people with Type 1 diabetes, skipping insulin was most strongly associated with poorer dietary habits; among those with Type 2 diabetes, the strongest associations were with lower age, higher education, lower income, and greater pain and embarrassment with injections.

As a Diabetes Self-Management article notes, the survey also probed injection-related pain and anxiety in greater detail. A Web site dedicated to the survey results,, notes that 33% of respondents reported dreading injections, and 29% said that injecting insulin was the hardest part of their diabetes routine. Yet just over half of respondents said they did not raise quality-of-life concerns with their health-care team; 37% thought it would be a burden on their care provider to bring up the topic. In a separate survey of 300 health-care providers, only 12% said that they tended to hear concerns from patients about the impact of injections on their lives.

Have you ever intentionally skipped an insulin dose? If so, why? Have you discussed injection-related concerns with your doctor, whether or not you skipped a dose because of them? Do you have any tips for lessening pain, embarrassment, or inconvenience associated with injections? Leave a comment below!

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