In an accompanying editorial, researchers from the Department of Psychiatry at Harvard Medical School and the Joslin Diabetes Center pointed out that U.S. physicians often delay insulin therapy for patients and that Americans frequently resist such treatments. "Physicians need to identify and address patients' beliefs about insulin and examine their own reluctance to initiate insulin treatment," they wrote.

Risk factors for failing to comply with insulin regimens differed between those who had type 1 and those who had type 2 diabetes. The researchers found diet non-adherence to be a more prominent risk factor for missing injections in type 1 patients, whereas younger age, lower income, and perceived pain and embarrassment were more prominent as risk factors for people with type 2.

More than 25 percent of people with diabetes must inject themselves with insulin on a daily basis. All people with type 1 diabetes and many people with type 2 diabetes need insulin to manage their disease and to prevent or slow the progression of dangerous complications.