Many docs reluctant to prescribe insulin

Many doctors delay prescribing Diabetes drugs or insulin to patients with Type 2 diabetes for as long as possible, a new international study shows.

This can be a bad thing for patients, Dr. Mark Peyrot, the study's lead author, told Reuters Health, because effective control of blood sugar is key to preventing serious complications.

Peyrot, a sociologist at Loyola College in Baltimore, points out that Type 2 diabetes is progressive. While diet and exercise can help, he added, many patients may eventually need medications, including insulin, to control their blood sugar.

"Physicians are often not inclined to tell patients that they need medication, and what we see happening as a result of that is that they often try and emphasize methods that are not as powerful as they could be," he said.

Peyrot and his colleagues surveyed 3,790 doctors and nurses in 13 countries about their attitudes toward insulin and 2,061 patients with Type 2 diabetes who were not taking insulin.

Novo Nordisk, which manufactures insulin and insulin delivery systems, funded the study.

More than half of the physicians reported "threatening" their patients with needing insulin if they did not take a more active role in controlling their blood sugar. And 50% to 55% of doctors and nurses said they would delay prescribing insulin until "absolutely necessary."

Patients often said they would blame themselves if they wound up needing to take insulin, while those who ate better, exercised more and were less distressed about their Diabetes were less likely to say they would blame themselves.

People are often afraid of taking insulin, Peyrot noted, but should realize that it is a powerful and effective medication with few side effects.

"The issue should be to concentrate on getting the blood glucose down using whatever strategies you need to," he added. "Patients should be demanding this of their physicians."

SOURCE: Diabetes Care, November 2005.