Skipping Insulin Injections – What are the Risk Factors?

January 26, 2010

More than half of people with diabetes who take insulin injections to control their diabetes say they have intentionally skipped an injection, with one-fifth of them reporting that they do so “sometimes” or “often,” according to a study being published this month in Diabetes Care.

Using an Internet survey of more than 500 U.S. adults, the study found that 57% of survey respondents with either type 1 or type 2 diabetes purposefully failed to take their insulin shots at least occasionally. It also found that older patients, those who were disabled, those who followed a healthy diet and those with higher household incomes were more likely to take their shots at the frequency prescribed. Students, those with type 2 diabetes, and those who took more injections were more likely to skip them. Additionally, those who perceived more injection-related problems, such as interference with daily activities and injection pain and embarrassment, were more likely to skip injections.

“Intentionally skipping insulin injections may be more common than clinicians think,” said lead researcher Mark Peyrot, PhD, Department of Sociology, Loyola University Maryland. “It’s important for physicians and other health care professionals to be aware of potential risk factors, especially for patients who report injection-related problems. We hope that in the future doctors will work closer with patients to determine their individual needs, so that they can better plan activities to facilitate patients’ adherence with their treatment regimens.”

In an accompanying editorial, researchers from the Department of Psychiatry at Harvard Medical School and the Joslin Diabetes Center pointed out that U.S. physicians often delay insulin therapy for patients and that Americans frequently resist such treatments. “Physicians need to identify and address patients’ beliefs about insulin and examine their own reluctance to initiate insulin treatment,” they wrote.

Risk factors for failing to comply with insulin regimens differed between those who had type 1 and those who had type 2 diabetes. The researchers found diet non-adherence to be a more prominent risk factor for missing injections in type 1 patients, whereas younger age, lower income, and perceived pain and embarrassment were more prominent as risk factors for people with type 2.

More than 25 percent of people with diabetes must inject themselves with insulin on a daily basis. All people with type 1 diabetes and many people with type 2 diabetes need insulin to manage their disease and to prevent or slow the progression of dangerous complications.

To reach lead researcher Dr. Mark Peyrot, phone: 410-916-9759 or email: To reach editorial writer Katie Weinger, EdD, Joslin Diabetes Center, phone: 617-732-2488 or email:

Diabetes Care, published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into one of the nation’s leading causes of death by disease.  Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure and non-traumatic amputations.

About the American Diabetes Association

Nearly half of American adults have diabetes or prediabetes; more than 30 million adults and children have diabetes; and every 21 seconds, another individual is diagnosed with diabetes in the U.S. Founded in 1940, the American Diabetes Association (ADA) is the nation’s leading voluntary health organization whose mission is to prevent and cure diabetes, and to improve the lives of all people affected by diabetes. The ADA drives discovery by funding research to treat, manage and prevent all types of diabetes, as well as to search for cures; raises voice to the urgency of the diabetes epidemic; and works to safeguard policies and programs that protect people with diabetes. In addition, the ADA supports people living with diabetes, those at risk of developing diabetes, and the health care professionals who serve them through information and programs that can improve health outcomes and quality of life. For more information, please call the ADA at 1-800-DIABETES (1-800-342-2383) or visit Information from both of these sources is available in English and Spanish. Find us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn)