Insulinophobia: Existence of an Infamous Reality In Primary Health Care

Objective: To study the knowledge and approach towards insulin use among primary care physicians. Method: This observational study was conducted using a validated questionnaire among primay care physician who had complete their bachelor of medicine and bachelor of surgery and involved in primary care practice at government and private sectors. Physicians with additional specialization were not invited for the study. Results: Among 125 physicians response , Thirty seven (29.6%) physicians responded insulin requirement many not be needed for type II diabetes patients initially irrespective of their blood sugar level and Thirty seven (29.6%) has second opinion to initiate insulin for type II diabetes patients. Significant difference is seen among physicians with less than five years of experience in terms of calculating insulin requirement (p-0.028) initiating insulin regimen( p-0.001) for diabetic patients. 89 (71.2%) physicians are worried of hypoglycaemia to initiate insulin regimen by themselves. Conclusion: More training and encouragement is needed among primary care physician to initiate insulin therapy among diabetes patients which in turn reduces overall diabetes related morbidity and mortality. Special Training should be given from the period of internship regarding diabetes management using insulin protocol.

Key words: Diabetes mellitus, Insulin regimen, Insulin use in primary care, Insulinophobia, Underutilization of insulin.