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Decision Making in Insulin Therapy (DMIT) Project


Project Title

Developing and pilot-testing an intervention for patients with type 2 diabetes who are making decisions about starting insulin therapy


Why is this project important?

  • The incidence of type 2 diabetes is increasing in Malaysia and globally.
  • One important reason of poor sugar control is the delay in stepping up treatment regimen such as insulin therapy. The National Health Morbidity Survey in 2006 showed only 7.2% insulin usage both alone and in combination with oral anti-diabetics despite suboptimal diabetes control.
  • There are many barriers in starting insulin treatment which include patient factors such as fear of needle and pain, hypoglycaemia, weight gain, cost and social stigma; doctor factors such as lack of training in insulin initiation; and system factors such as lack of support services and costs.
  • Few interventions have been developed to help clinicians and patients overcome these barriers.


  • To develop an intervention to help patients with type 2 diabetes who are considering insulin therapy to make an informed decision.
  • The ultimate aim is to develop a practical decision-making tool which can be evaluated and implemented in the primary care setting across Malaysia.
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