Table 3.

Factors affecting adherence and persistence to insulin therapy

Factors that improve adherence and persistence	Factors that lower adherence and persistence
Using analog insulin rather than human or animal-derived insulin [90]	Having high baseline hypoglycemia or fear of hypoglycemia [64, 90–92]
Using basal insulin rather than rapid- or short-acting insulin [2]	Having high comorbidity burden [90]
Being in age group (40–69) [90]	Experiencing or having fear of weight gain [92, 93]
Experiencing improved glycemic control [93]	Experiencing or having fear of pain from injection [64, 93]
Having access to support system formed primarily of physicians and healthcare professionals [93]	Feeling financially burdened [64, 94]
Using injection pen rather than vial or syringe [63]	Having complex regimen [64]
Having been treated for diabetes for longer duration [64]	Starting with higher dose [64]
Having higher baseline HbA1c level [90, 92]	Feeling that insulin treatment interferes with daily activities [64]