Table 3 Factors affecting adherence and persistence to insulin therapy

Using analog insulin rather than human or animal-derived insulin [90]

Having high baseline hypoglycemia or fear of hypoglycemia [64, 90,91,92]

Using basal insulin rather than rapid- or short-acting insulin [2]

Having high comorbidity burden [90]

Being in age group (40–69) [90]

Experiencing or having fear of weight gain [92, 93]

Experiencing improved glycemic control [93]

Experiencing or having fear of pain from injection [64, 93]

Having access to support system formed primarily of physicians and healthcare professionals [93]

Feeling financially burdened [64, 94]

Using injection pen rather than vial or syringe [63]

Having complex regimen [64]

Having been treated for diabetes for longer duration [64]

Starting with higher dose [64]

Having higher baseline HbA1c level [90, 92]

Feeling that insulin treatment interferes with daily activities [64]