The ACBRD has worked with Diabetes Australia to produce a booklet designed to support people with type 2 diabetes who want to find out more about insulin
By Jasmine Schipp 
A common misconception is that insulin is only for people with type 1 diabetes. In fact, in Australia more people with type 2 diabetes  take insulin than there are people diagnosed with type 1 diabetes. Unfortunately, starting insulin is often delayed for people with type 2 diabetes; 1 in 4  Australians with type 2 diabetes report that they would not use insulin even if their health professional recommends it. People with type 2 diabetes commonly report myths, misconceptions, and fears around starting insulin. Furthermore, many report that the benefits and side-effects of insulin are not well explained to them.
Our research suggested that there was a need for more resources for people with type 2 diabetes to learn more about insulin. We conducted an audit of freely and publicly available resources to see what was missing. We found that there was a lack of information that was: credible (developed by a diabetes organisation), local (Australian), comprehensive (including both side-effects and benefits of insulin), acknowledging the psychological barriers to starting insulin , and acknowledging insulin initiation as a decision made by the person with diabetes with their health professional. To address this, we collaborated with Diabetes Australia  to create a new NDSS * booklet: ‘Starting Insulin ’ is designed to support people with type 2 diabetes to better understand the role of insulin in their self-care, and to make an informed decision about starting insulin therapy.
Before we started writing the booklet, we invited people with type 2 diabetes (representing different age groups, cultural backgrounds and medication experiences) to take part in a ‘focus group’. The group discussed what an ideal resource would look like, and compared existing resources from other countries. Once we had a draft of the new booklet, we invited the focus group participants back for an interview where we asked them for general and specific feedback on the booklet. Overall, the feedback was overwhelmingly positive but we also received some very useful suggestions for improvements. For example, changing the title of the resource, and including more quotes and images. We considered all of the feedback provided and made the suggested changes where appropriate. We also convened an advisory group of health professionals with expertise in type 2 diabetes and insulin therapy. The advisory group also provided valuable feedback throughout the development process.
The final version of the Starting Insulin  booklet covers a range of topics, including:
- About this booklet and using this booklet
- Understanding my diabetes and the role of insulin
- Options for managing my diabetes
- How to know if my blood glucose is ‘within target’
- Insulin: why, when, who, how and what?
- Benefits and side-effects of insulin
- Frequently asked questions about insulin
- So, how do I feel now about starting insulin?
- Discussing insulin with my health care team
- Where can I find more information and support?
Starting Insulin  is now freely available via the NDSS website.
To read more on concerns about starting insulin among people with type 2 diabetes, check out our blogs on psychological insulin resistance , or read about our research theme ‘Psychological barriers to treatment intensification for type 2 diabetes’ .
* The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered with the assistance of Diabetes Australia.
This booklet was funded by the NDSS and developed by Dr Elizabeth Holmes-Truscott  and Professor Jane Speight  with input from people with type 2 diabetes. We are thankful for expert input from a range of health professionals with expertise in type 2 diabetes and insulin: Associate Professor Neale Cohen  (Baker Heart and Diabetes Institute), Eileen Collins  (Diabetes Victoria), Associate Professor John Furler  (University of Melbourne), Sophie McGough  (Diabetes WA), Sue Leahy  (Diabetes NSW & ACT) and Caroline Wells  (CEO: Diabetes Tasmania). The booklet was designed by Nino Soeradinata  (Diabetes Victoria). We also acknowledge the support of our ACBRD staff Jasmine Schipp  and Victoria Yutronich .