Sanjay Kalra and Sarita Bajaj and Surendra Kumar Sharma and Gagan Priya and Manash P and Baruah and Debmalya Sanyal and Sambit Das and Tirthankar Chaudhury and Kalyan Kumar and Gangopadhyay and Ashok Kumar Das and Bipin Sethi and Vageesh Ayyar and Shehla Shaikh and Parag Shah and Sushil Jindal and Vaishali Deshmukh and Joel Dave and Aslam Amod and Ansumali Joshi and Sunil Pokharel and Faruque Pathan and Faria Afsana and Indrajit Prasad and Moosa Murad and Soebagijo Adi Soelistijo and Johanes Purwoto and Zanariah Hussein and Lee Chung Horn and Rakesh Sahay and Noel Somasundaram and Charles Antonypillai and Manilka Sumanathilaka and Uditha Bulugahapitiya (2020) A Practitioner’s Toolkit for Insulin Motivation in Adults with Type 1 and Type 2 Diabetes Mellitus: Evidence-Based Recommendations from an International Expert Panel. Diabetes Therapy, 11 (8). pp. 585-606. ISSN 1869-6961

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Abstract

Aim To develop an evidence-based expert group opinion on the role of insulin motivation to overcome insulin distress during different stages of insulin therapy and to propose a practitioner’s toolkit for insulin motivation in the management of diabetes mellitus (DM). Background Insulin distress, an emotional response of the patient to the suggested use of insulin, acts as a major barrier to insulin therapy in the management of DM. Addressing patient-, physician- and drug-related factors is important to overcome insulin distress. Strengthening of communication between physicians and patients with diabetes and enhancing the patients' coping skills are prerequisites to create a sense of comfort with the use of insulin. Insulin motivation is key to achieving targeted goals in diabetes care. A group of endocrinologists came together at an international meeting held in India to develop tool kits that would aid a practitioner in implementing insulin motivation strategies at different stages of the journey through insulin therapy, including pre-initiation, initiation, titration and intensification. During the meeting, emphasis was placed on the challenges and limitations faced by both physicians and patients with diabetes during each stage of the journey through insulinization. Review Results After review of evidence and discussions, the expert group provided recommendations on strategies for improved insulin acceptance, empowering behavior change in patients with DM, approaches for motivating patients to initiate and maintain insulin therapy and best practices for insulin motivation at the pre-initiation, initiation, titration and intensification stages of insulin therapy. Conclusions In the management of DM, bringing in positive behavioral change by motivating the patient to improve treatment adherence helps overcome insulin distress and achieve treatment goals.

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