Part of the Treating to Target in Type 2 Diabetes (4-T) trial involved exploring participants' reactions to their intensifying insulin therapy.
In Diabetic Medicine we, along with Nick Jenkins & Julia Lawton of the University of Edinburgh, present a series of qualitative interviews from the trial with participants who had had their insulin therapy intensified.
Following intensification, participants tried to remember to take their additional injections by developing injection-related daily routines. The need to inject insulin whilst in public seemed to be more of a concern following intensification, and was a consistent source of anxiety. Those who were worried about injecting in public tried to avoid having to do so: by injecting in toilets, for example, or by advancing or delaying the timing of their injections.
So, it was not increasing the number of daily injections that was a problem for those whose insulin therapies intensified, but the increased likelihood of having to inject insulin in public. Addressing concerns about injecting in public places, we suggest, might help patients conform to their treatment schedules.