Original research| Volume 8, ISSUE 4, P338-345, December 2014

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Insulin adherence in patients with diabetes: Risk factors for injection omission

  • Shadi Farsaei
    Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
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  • Mania Radfar
    Corresponding author at: Enqelab SQ, Poursina Av. PO Box: 14155/6451, Tehran, Iran. Tel.: +98 21 6695470; fax: +98 21 66954709.
    Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

    Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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  • Zahra Heydari
    Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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  • Farzaneh Abbasi
    Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Growth and Development Research Center, Children Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
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  • Mostafa Qorbani
    Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran

    Department of Epidemiology, Iran University of Medical Sciences, Tehran, Iran
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Published:April 09, 2014DOI:



      The purpose of this study was to evaluate adherence to insulin therapy in patients with diabetes. The underlying factors affecting insulin injection omission among patients with type 1 or 2 diabetes were also investigated.


      This cross-sectional study has been conducted on 507 patients with diabetes. Adherence to insulin therapy was measured by the 8-Item Moriskey Medication Adherence Scale (MMS) and the autocompliance method. Furthermore, socio-demographic, disease and injection-related barriers to insulin injection were assessed.


      Based on the Morisky Green test, 14.3% and 28.8% of patients with type 1 and 2 diabetes respectively had low adherence to insulin therapy. However, almost all patients were adherent according to the autocompliance method. Different factors showed a significant association with insulin compliance in both groups.


      The current study suggests acceptable adherence to insulin therapy among patients with type 1, and poor adherence in patients with type 2, diabetes. Our findings regarding barriers with significant effect on insulin adherence may be useful to identify patients at risk for low compliance, and to guide the design of proper strategies to improve adherence and the consequential clinical outcomes.


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