What are the expectations and experiences of non-insulin injectables among adults with type 2 diabetes?

Our Centre’s research shows how experiences and expectations may shape attitudes to future use of insulin treatment

By Dr Roslyn Le Gautier

For people with type 2 diabetes, there is a class of medication called glucagon-like-peptide-1 receptor agonists (GLP-1RAs). It is not a tablet. It is an injection. But, it’s not insulin. GLP-1RAs offer benefits for reducing glucose levels, weight and for cardiovascular health. Importantly, it doesn’t cause low glucose (hypos). Unfortunately, there can be some short-term side effects, e.g. nausea, vomiting.

Research shows that awareness of common concerns and experiences of diabetes medication use is important for improving clinical care and support.

While we know a lot about the experiences of insulin use among Australian adults, very little is known about their experiences and expectations of GLP-1RAs.

To find out more, Dr Elizabeth Holmes-Truscott and colleagues asked 19 Australian adults with type 2 diabetes to share their recent experiences with GLP-1RAs. Here’s what they found:

      • Beliefs and attitudes about insulin influence initial concerns about GLP-1RAs. People fear that GLP-1RA use means that their diabetes is getting worse. They also worry about other people judging them if they need to inject in public.
      • Some people find injections less painful than they expected. So, they become less nervous about using a needle after a short trial.
      • People view GLP-1RA use more positively when it does not disrupt their daily routines. Weekly injections are seen as more convenient than daily injections.
      • When the GLP-1RA treatment has the expected benefits (e.g. reducing glucose levels), emotional well-being improves. However, unmet expectations can lead to disappointment and sometimes to stopping the treatment.
      • Experiences of side effects vary. Some people have no side effects while others feel nauseous. These side effects often disappear after a few weeks.

This study shows that concerns about GLP-1RA are similar to concerns raised about insulin use in previous research. For health professionals, early discussions of GLP-1RA treatment are a good opportunity to address concerns. This may also help support future use of insulin treatment if it is needed.

If you enjoyed reading this, check out our other blogs on type 2 diabetes and medication use

Citation: Holmes-Truscott E, Schipp J, Dunning T, Furler J, Hagger V, Holloway E, Manski-Nankervis JA, Shaw JE, Skinner TC, Speight J. ‘For me, it didn’t seem as drastic a step as being controlled by insulin’: a qualitative investigation of expectations and experiences of non-insulin injectable therapy among adults with type 2 diabetes. Diabetic Medicine, 2022, 39(2): https://doi.org/10.1111/dme.14681

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