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. 2020 Apr 3;13:1023–1033. doi: 10.2147/DMSO.S237948

Table 3.

Self-Reported Reasons for Different Persistence Patterns

Total N = 154
Continuation (n=52)
Motivations for continuation of basal insulin, n (%)
Improved glycemic control 41 78.8%
Belief that insulin is best for reducing risk of complications of diabetes 33 63.5%
Instruction by physician/healthcare provider to continue 28 53.8%
Improved physical feeling 23 44.2%
Improved emotional wellbeing 13 25.0%
Convenience of insulin relative to other diabetes treatments 12 23.1%
Interruption (n=52)
More than one interruption, n (%) 40 76.9%
Factors contributing to interruption, n (%)
Weight gain 18 34.6%
Fear of potential side effects of insulin use 16 30.8%
Hypoglycemia 12 23.1%
Inconvenience of using insulin 12 23.1%
Instruction by physician/healthcare provider to stop 11 21.2%
Assessing whether diabetes could be managed without insulin 11 21.2%
Cost of insulin therapy 10 19.2%
Pain from injections 9 17.3%
Preference for oral antidiabetic medications 8 15.4%
Dislike/fear of needles 7 13.5%
Insufficient glycemic control with insulin 6 11.5%
Other 2 3.8%
Factors contributing to restarting basal insulin, n (%)
Persuasion by physician/healthcare provider to restart 36 69.2%
Persuasion by friends/family to restart 19 36.5%
Insufficient glycemic control without insulin 18 34.6%
Resolution of the issue that led to interruption 8 15.4%
Other 2 3.8%
Discontinuation (n=50)
Factors contributing to discontinuation, n (%)
Instruction by physician/healthcare provider to stop 23 46.0%
Weight gain 15 30.0%
Hypoglycemia 12 24.0%
Dislike/fear of needles 10 20.0%
Preference for oral antidiabetic medications 10 20.0%
Cost of insulin therapy 10 20.0%
Insufficient glycemic control with insulin 8 16.0%
Sense that diabetes could be managed without insulin 7 14.0%
Pain from injections 6 12.0%
Inconvenience of using insulin 5 10.0%
Fear of potential side effects of insulin use 3 6.0%
Perception of insulin use by others 1 2.0%
Other 6 12.0%
Factors that could contribute to restarting basal insulin, n (%)
Persuasion by physician/healthcare provider to restart 27 54.0%
Insufficient glycemic control without insulin 22 44.0%
Persuasion by friends/family to restart 12 24.0%
Nothing 6 12.0%
Other 2 4.0%

Notes: Continuers had no gaps of ≥7 days in basal insulin treatment. Interrupters stopped basal insulin for ≥7 days within the first 6 months after initiation and since restarted basal insulin. Discontinuers stopped using basal insulin for ≥7 days within the first 6 months after initiation and had not restarted basal insulin by the time of the survey.