Refusal of insulin therapy results in an average of a year’s delay for patients with type 2 diabetes to achieve glycaemic control, compared with those who accept their doctor’s advice, a US study shows.

Harvard University-led investigators looked at patient records at two large Boston hospitals between 2000 and 2014 and found that 43% of 5300 people with diabetes (and HbA1c above 53mmol/mol) declined their doctor’s first recommendation to use insulin.