57% of diabetics occasionally skip insulin shots on purpose

It’s fairly common for people with diabetes to skip insulin shots, new research suggests. More than half of those with the disease who take insulin — which helps lower blood glucose levels — say they have intentionally omitted shots, a study published this week in Diabetes Care says. “Skipping insulin shots is more common than many people thought,” says medical sociologist and lead study author Mark Peyrot of Loyola University Maryland and Johns Hopkins.

Peyrot and colleagues analyzed data collected from an Internet survey of 500 people with diabetes and found that 57% choose not to take their insulin shots occasionally. One out of five patients said they skipped shots regularly.

Younger patients, people with type 2 diabetes, lower income earners, people prescribed more daily injections, higher-educated respondents and patients not following a healthful diet are more likely to cut back on shots. Among the reasons given for skipping insulin: interference with daily activities, injection pain and embarrassment about taking medication around others.

In an accompanying editorial, Katie Weinger of Harvard Medical School’s department of psychiatry says one danger of insulin omission is that doctors who treat patients with low adherence may mistake poor blood glucose readings for the need for more insulin. If those patients are then prescribed higher doses, hypoglycemic episodes may occur, she says.

An e-mail-based survey can have limitations, says endocrinologist Nicolas Musi of the Texas Health Science Center in San Antonio. “Not everyone will take the time to think about the answers they’re putting down,” Musi says.

But Musi says the study has value. “It’s important for patients to know their physicians won’t be angry at them if they’re not using their insulin as told,” he says. “It’s always best to be open so we can work together to find solutions.”