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Objectives: This study aimed to identify the main barriers that prevent patients with diabetes mellitus from accepting insulin therapy. Methods: This cross-sectional study was conducted from May to December 2019. Convenience sampling was used to recruit participants from three diabetes clinics in Muscat, Oman. Eligible participants were interviewed in person based on a pre-prepared questionnaire. The questionnaire, which was administered in Arabic, includes demographic data and 19 specific items on barriers to insulin therapy. Results: A total of 201 participants (response rate: 93%) were enrolled in the study. The most common barriers were as follows: concern of frequent blood glucose checking (36.3%), long-term injections (33.8%), side-effects of insulin (29.9%) and weight gain (29.4%). Needle phobia was considered a barrier by only 9% of the participants. Overall, 125 (62.2%) participants were willing to initiate insulin therapy despite the presence of these barriers and only 20 (10%) of them were influenced by these barriers to such a degree that they rejected the insulin therapy. Conclusion: The majority of participants had no identifiable reasons to stop them from accepting insulin therapy. Effective strategies should be developed to address each of the main barriers to improve acceptance and adherence to insulin therapy.
Keywords: Diabetes Mellitus; Insulin; Treatment Refusal; Needles; Phobic Disorders; Hypoglycemia; Weight Gain; Oman.

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Al Futaisi, A., Alosali, M., Al-Kazrooni, A., Al-Qassabi, S., Al-Gharabi, S., Panchatcharam, S., & Al-Mahrezi, A. M. (2022). Assessing Barriers to Insulin Therapy among Omani Diabetic Patients Attending Three Main Diabetes Clinics in Muscat, Oman. Sultan Qaboos University Medical Journal, 22(4), 525–531.