Quality of Life and Insulin Therapy in Type 2 Diabetes Mellitus

• Published in: Insulin Vol. 3; no. 1; pp. 31 - 36
• Main Author: Funnell, Martha M.
• Format: Journal Article
• Language: English
• Published: 2008
• Subjects: barriers; insulin; quality of life; type 2 diabetes mellitus; type 2 diabetes mellitus; barriers; insulin; quality of life
• ISSN: 1557-0843; 1878-7525
• DOI: 10.1016/S1557-0843(08)80009-7

Background: A frequently cited barrier to insulin use in type 2 diabetes mellitus (DM) is concern about the adverse effects on quality of life. Results of studies in this area have been mixed, with insulin use showing decreased, enhanced, or no impact on quality of life. Objective: The purpose of this paper is to discuss the state of the science regarding the effects of insulin on quality of life and to present strategies providers can implement in their clinical practices to decrease barriers to insulin use among patients with type 2 DM. Methods: An English-language MEDLINE search of the current literature using the terms insulin and quality of life was conducted for this article. Results: Although patient-identified concerns regarding insulin use represent some aspects of quality of life, study results have been mixed. However, 2 large studies examining the use of insulin glargine and its effects on quality of life found that glargine was associated with significantly greater improvements in quality of life when added to oral antidiabetic agents (OADs) than was the use of OADs alone. Another study examined the effects of intensive multi- therapy (monthly visits, self-management diabetes education, and medication adjustments) on quality of life among patients with type 2 DM and found that quality-of-life scores improved among patients who initiated insulin therapy during the trial. The effects of insulin delivery systems on quality of life have also been assessed. In these studies, patients preferred insulin pens over vials and syringes and inhaled over injected insulin. Health care providers can facilitate acceptance of insulin by employing strategies to help patients overcome psychological barriers to insulin therapy. Conclusions: Although patient concerns about the effects of insulin use are legitimate, insulin therapy is often needed to achieve treatment targets. Providers can reduce the impact on quality of life by addressing barriers, helping patients improve metabolic control, and providing ongoing information and support.