BARRIERS FACING PHYSICIANS TO INITIATE INSULIN THERAPY FOR TYPE 2 DIABETES PATIENTS IN PRIMARY HEALTH CARE CENTERS, JEDDAH 2018

Background: diabetes considered as a big health problem in Saudi Arabia. Uncontrolled hyperglycemia among diabetic patients and Unwillingness of physicians to initiate insulin is an apparent issue. While the majority of those patients follow up with primary health care physicians as they are the first line for health care system, few numbers of patients reach their diabetes control. Little is known about the barriers facing physicians to initiate insulin therapy in patients with type 2 diabetes. Subjects and methods: a cross sectional analytical study was done among a sample of 211 physicians working at primary health care Centers ,MOH ,Jeddah, during the period between 1st till 30 th October 2018 , using self-administered questionnaires about demographic data and reflecting barriers related to doctors ,system and patients. Main results: the study results revealed that majority of study sample 84.8% agreed that barriers for insulin initiation to type 2 diabetic patients were barriers related to patients , while 13.8% of them disagreed about these barriers. As regard to barriers related to institution, 61.1% disagreed about it and only few numbers about 3.8% agreed. with a correlation related to age of physicians. About 63.5% of our sample were neutral to barriers related to physicians , while 14,2% agreed and 22,3,% disagreed to presence of barriers . Most of the barriers related to physicians affected by age and experience factors, with increasing age and experience there was less barriers Conclusion: This study identified numerous barriers facing physicians to initiating insulin among type 2 diabetic patients in primary health care centers.it found that most of these barriers related to patients rather than doctors or institutional barriers .Patients related barriers as fear of side effects (hypoglycemia and ⁄ or weight gain) and patients education had the greateast percentage to their acceptance of insulin therapy and overcoming these barriers will require more education and councelling of patients with multidisplinary team in primary health care centers. Key words: Diabetes, Insulin, Barriers, physicians, Saudi Arabi