A Lahore-based survey reveals that patient fears, inadequate education, and systemic shortcomings delay insulin use among Pakistani diabetics, highlighting the need for structural reforms and targeted clinician training.
A new survey from Lahore has put hard numbers on a problem Pakistani clinicians have long described anecdotally: insulin is still reaching patients too late, or not at all, because fear, misunderstanding and weak support systems continue to slow its use. Published in Health Science Reports, the study examined responses from 808 physicians working at a public-sector tertiary hospital and found that lack of patient education, fear of hypoglycaemia and the complexity of insulin delivery were among the most commonly reported barriers. The findings sit within a wider Pakistani evidence base showing that both healthcare professionals and patients often struggle with insulin knowledge, confidence and acceptance. The theme is consistent across several local studies: when diabetes education is weak, insulin use suffers.
The Lahore team, led by researchers at the University of Lahore, gathered data between September 2024 and February 2025 from doctors in internal medicine, endocrinology, gastroenterology and nephrology. Their results suggest that therapeutic inertia in diabetes care is not driven by one obstacle but by a layered mix of patient fears, doctor experience and system shortcomings. Physicians reported that patients often resist insulin because they worry about hypoglycaemia, injection pain, weight gain and the burden of lifelong treatment. That picture matches earlier Pakistani and regional research, including studies describing psychological insulin resistance, public embarrassment over injections and persistent misconceptions that insulin causes blindness, kidney failure or other severe complications.
The survey also showed that barriers were not experienced evenly across the medical workforce. Differences emerged by qualification, years in practice and sex, with more experienced clinicians generally reporting fewer difficulties. The authors said this points to a skill set that can be learned over time: counselling patients more effectively, handling cultural concerns and explaining treatment choices with greater confidence. That interpretation is in line with earlier work on insulin prescribing in Pakistan, which has highlighted gaps in professional training, low confidence in insulin-related decision-making and the value of targeted education for clinicians.
What makes the study especially useful is that it does not stop at diagnosis. Physicians were asked what would help them overcome these barriers, and their answers were strikingly practical. They called for diabetes educators, regular follow-up, clearer patient information, better access to prescribing tools and closer collaboration with diabetes specialists. They also favoured communication that combines written instructions, verbal counselling and shared decision-making. These suggestions echo international and regional findings that patient education, structured follow-up and decision support can improve insulin acceptance and adherence, particularly where literacy is limited and misconceptions are common.
The broader significance extends beyond one hospital in Lahore. Pakistan carries one of the world’s heaviest diabetes burdens, and earlier local studies have shown that people with type 2 diabetes frequently delay insulin because they fear needles, public stigma or a permanent commitment to treatment. The Lahore survey adds the clinician’s view to that picture and suggests that the bottleneck is not simply medical judgement, but the environment around it: education, follow-up, affordability and institutional support. In that sense, the study is less a report on insulin than a diagnosis of the system that surrounds it.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
