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Updated: Mar 22, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Measuring insulin adherence among adults with type 2 diabetes
Chandra Y Osborn1, Jeffery S Gonzalez2,3
1Department of Medicine, Department of Biomedical Informatics, Center for Health and Health Education, Vanderbilt University Medical Center, 2525 West End Ave. Suite 370, Nashville, TN, 37203, USA. chandra.osborn@vanderbilt.edu.
Abstract:
Non-adherence to insulin is common and associated with suboptimal health. We adapted the Morisky Medication Adherence Scale to specify insulin adherence (MIAS) and compared it to the Adherence to Refills and Medication Scale for Diabetes (ARMS-D) and the Summary of Diabetes Self-Care Activities medications subscale (SDSCA-MS) and an insulin-specific (SDSCA-IS) version. A sample of 144 insulin-treated adults (58 % African American/Black, 34 % Caucasian/White, 8 % Other/Mixed race; 6.9 % Hispanic) completed these measures along with a HbA1C test. The internal consistency and factor structure of the MIAS were adequate; 59 % of participants forgot to take insulin and 46 % reported non-adherence. The MIAS was associated with the ARMS-D, SDSCA-MS, and SDSCA-IS (p < 0.001), and higher MIAS scores were marginally associated with better self-rated health (p = 0.057), but significantly associated with fewer emergency room visits (p = 0.001), and better HbA1C (p = 0.001). The MIAS is a valid and reliable insulin adherence assessment tool for practice and research applications.
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