Successful Healthcare Provider Strategies to Overcome Psychological Insulin Resistance in Japanese Patients with Type 2 Diabetes

The increasing prevalence of type 2 diabetes mellitus (T2D) is a major health concern globally. In Japan, the prevalence of diabetes is predicted to increase over the next decades. Insulin is a hormone which keeps blood glucose levels within the normal range. People with diabetes often require insulin therapy as they do not make sufficient insulin, or the insulin that is produced does not work optimally. Many patients delay insulin therapy due to a variety of factors. Reluctance to begin insulin treatment is known as ‘psychological insulin resistance’ (PIR). Several studies have described recommendations to address PIR, but there is little research regarding effective strategies that help reluctant patients begin insulin. Reports describing PIR among Japanese patients are limited. EMOTION was a multinational study surveying insulin-using adults with T2D and initial PIR. We report a Japanese population subanalysis of EMOTION, identifying factors which help reluctant Japanese patients begin insulin therapy. Our results indicate that healthcare provider (HCP) actions are associated with a patient’s decision to use insulin. Practical demonstrations by HCPs on how to use insulin were reported as most helpful. Reassurance concerning pain of injection, explanations regarding blood glucose numbers and future health, encouragement to make contact in case of any problems, and occurrence of a positive life event were also rated by Japanese participants as being helpful in deciding to commence insulin. This study provides important information on actions that can be used by HCPs to treat Japanese patients with T2D who are reluctant to begin insulin treatment.