TABLE 1.

Commonly Reported Cultural Barriers to Insulin Use Among Hispanics/Latinos, African Americans, and Asians

Racial/Ethnic GroupPerceptions of InsulinFamilySocial FactorsReligion
Hispanics/Latinos• Insulin may be believed to cause more complications or harm
• Insulin use may be believed to imply failure
• Fear of insulin injections
• Lack of family support may delay insulin initiation
• Family members may influence patients not to use insulin
• Fatalistic views are common
• Insulin use may be viewed as a burden on the family
• Insulin use may be seen as interfering with daily life
• Patients may use prayer as an intervention to manage diabetes and improve health
• Diabetes may be viewed as a punishment
African Americans• Insulin may be believed to lead to organ damage
• Insulin may be believed to cause negative emotions
• Insulin use demands a new mindset
• Fear of insulin injections
• Patients often value family support
• Patients often value family input
• Fatalistic views are common
• Insulin use may be seen as interfering with schedule
• Injections may be viewed as inconvenient
• Insulin use may cause feelings of embarrassment
• Patients may use prayer to cope with diabetes management
• Patients may use prayer to help change unhealthy behaviors
Asians• Insulin use may imply failure
• Insulin may be believed to lead to more complications
• Insulin may be believed to cause harm
• Fear of insulin injections
• Family support for insulin use may be unattainable• Insulin may be viewed as a form of handicap
• Insulin use may be considered indicative of severe illness
• Insulin use may be seen as interfering with personal and social life
• Insulin use may cause feelings of embarrassment
• Insulin use may interfere with religious obligations
• Muslims may be concerned about insulin origins
• Insulin may be seen as making life less flexible