| Patient concerned with pain from injection |
| Minimal with thinner, smaller needles |
| Use of insulin pens |
| Patient worried that starting insulin signifies worsening diabetes |
| Diabetes is a progressive disease |
| Taking insulin will control blood glucose and help prevent complications |
| Taking insulin may slow down the rate of beta cell failure |
| Patient believes that need for insulin signifies patient failure to follow treatment regimen |
| Diabetes is a progressive disease; beta cell activity declines over time |
| Not related to patient compliance |
| Patient fears low blood sugar reactions |
| Explain that severe hypoglycemia is rare in type 2 diabetes |
| Self-monitoring glucose levels |
| Explain how to avoid and how to treat hypoglycemia |
| Patient concerned that taking insulin will upset daily routine |
| Address specific concerns |
| Taking insulin may be less intrusive than complicated drug regimens |
| Patient believes that insulin will decrease their quality of life |
| Benefits from glucose control: more energy, better sleep, overall well-being |
| Patient thinks insulin will lead to diabetic complications |
| Discuss role of insulin in reducing risk of diabetic complications |
| Patient concerned that they will be treated differently by friends and family |
| Educate friends and family: offer reading materials on diabetes, support groups |
| Patient has heard insulin causes weight gain |
| Role of diet and exercise |
| Patient wants a more natural alternative therapy |
| Insulin is the most natural therapy for diabetes. It is replacing the hormone that the patient does not make enough of. |
