Perceptions of insulin therapy in people with type 2 diabetes and physicians: a cross-sectional survey conducted in France

Emmanuel Cosson,1,2 Christine Mauchant,3 Imane Benabbad,3 Gilles Le Pape,4 Marion Le Bleis,3 Frédérique Bailleul,3 Jean-Daniel Lalau5,6 1Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, AP-HP, Bondy, Paris, France; 2Nutritional Epidemiology Research Unit, UMR U1153 INSERM/U11125 INRA/CNAM/Paris 13 University, Bobigny, Paris, France; 3Lilly France, Neuilly-sur-Seine, Paris, France; 4General Practice, Penmarch, France; 5Department of Endocrinology-Diabetology-Nutrition, Amiens University Medical Center, Amiens, France; 6PériTox Laboratory (UMR-I 01), Jules Verne University of Picardy, Amiens, France Objective: To evaluate perceptions of people with type 2 diabetes (T2D) and treating physicians living in France toward insulin therapy. Methods: Adults with T2D receiving oral glucose-lowering treatment alone (INS-) or basal insulin for ≥2 months (INS+) completed an online cross-sectional survey comprising 39 questions, including some regarding perceptions and fears of insulin therapy. Physicians were interviewed by telephone using eleven similar questions. The survey was designed by French clinicians experienced in treating diabetes and conducted under the auspices of an independent market-research agency. Results: The questionnaire was completed by 590 adults with T2D (two-thirds INS+) and 130 physicians (65 diabetologists/endocrinologists, 65 general practitioners). INS+ adults reported fewer negative feelings and more positive feelings than INS- adults. Two-thirds of INS+ adults reported that transitioning to insulin therapy was less difficult than expected. Overall, 44% of INS+ adults and 26% of physicians reported a fear of diabetic complications as being important, and 80% of physicians and 21% of INS+ adults considered injections to be a major patient fear. Conclusion: Most people with T2D reported that transitioning to insulin therapy was less difficult than they had feared. People with T2D and physicians exhibited differing perceptions regarding the transition. Reasons for the apprehension surrounding the transition to insulin therapy in people with T2D need to be better identified. Support from insulin-treated peers may enable this transition to occur with fewer anxieties in insulin-naïve people with T2D. Keywords: psychological insulin resistance, patient perceptions, physician perceptions, patient-physician relationship