胰岛素治疗已被证实为II型糖尿病患者口服药治疗失败时的有效措施。但无论是患者还是医生,对选择胰岛素都显得十分勉强。这种尽量延长开始胰岛素治疗时间的勉强性被称为“心理性胰岛素抵抗”。这种对胰岛素治疗的不情愿在一段时间内使II型糖尿病患者的血糖控制不佳,最终会导致神经病变、微血管病变和大血管病变并发症增加。在患者方面,对针头的恐惧、对低血糖以及体重增加的担心、注射治疗的不方便、传统保健观念以及学习自我注射所需的必要时间等,都是胰岛素应用的障碍。在医生方面,沟通技巧、指导方法以及发现和解决问题的意愿也影响患者的依从性。与患者一样,医生有时顾虑胰岛素治疗引起的低血糖和体重增加。在一项随机研究中,将近45%的糖尿病医生对于开始胰岛素治疗有顾虑,原因包括患者的拒绝、担心低血糖、担心 Insulin therapy has been shown to be an effective treatment for patients with type 2 diabetes who fail oral medication. But whether it is patients or doctors, the choice of insulin is very reluctant. This attempt to extend the time it takes to start insulin therapy is called “psychological insulin resistance.” This reluctance to insulin therapy has led to poor glycemic control in patients with type 2 diabetes over a period of time that eventually leads to increased neuropathy, microvascular disease, and macrovascular complications. On the patient side, fear of needles, concerns about hypoglycaemia and weight gain, inconvenience of injection therapy, traditional health-care concepts, and the time necessary to learn about self-injection are all barriers to insulin use. At the doctor’s level, communication skills, mentoring methods, and willingness to detect and solve problems also affect patient compliance. As with patients, doctors sometimes consider hypoglycemia and weight gain caused by insulin therapy. In a randomized study, nearly 45% of diabetologists were concerned with initiating insulin therapy due to patient rejection, hypoglycemia, worry