Patient barriers to insulin: The InfoCRIne order

Insulin is a life saving medicine. Yet, diabetes care professionals encounter many barriers to its use, especially at the patient level. This is even more true in primary care, where patients tend to resist injectable therapy. This article uses the mnemonic,InfoCRIne, to highlight four important barriers to insulin, and proposes bridges to overcome them. The bridges include information, confidence building, resource husbandry and individualization of strategy. These help overcome the barriers of hearsay, perceived inability to use insulin, perceived lack of resources and intrusion into lifestyle. This taxonomy is practical as well as pragmatic, and promotes a systematic approach towards initiation and acceptance of insulin therapy.