Qualitative research has explored barriers to insulin initiation among people with type 2 diabetes (T2D). However, unexplored areas include the influence of family/friends with insulin-treated diabetes (peers) on attitudes to / coping with treatment intensification, and the advice that people with T2D using insulin would offer to others. We investigated the perceived role of peers during/after insulin initiation, including the identification of key messages that participants perceived would be helpful to others considering insulin therapy.

Twenty semi-structured face-to-face interviews were conducted, audio recorded and transcribed. Eligible participants were adults with T2D, using insulin for <4 years. We conducted thematic inductive analysis using Nvivo 10.  

Participants were mostly men (n= 13, 65%), (median (range)) aged 65 (43-76) years, living with T2D for 11.5 (2-27) years, and using insulin for 2 (0.3-3.5) years. The majority had a friend or family member with type 1 diabetes or T2D using insulin. Familial experience of insulin prior to personal insulin initiation was associated with: insulin symbolising a more serious condition; feeling comfortable with injections due to prior exposure, or (for some) needle fear. After insulin initiation, while some participants shared stories with their peers about insulin use, many did not discuss diabetes at all. When asked about their advice for others with T2D, participants focused on having a positive attitude, on the benefits of insulin, ease of administration, and finding a trusted/supportive team of healthcare professionals. In spite of their experience with using insulin, some participants felt ill-equipped to offer advice to peers.

While most participants had family/friends using insulin, many reported not discussing diabetes and its treatment with peers. Participants willing to offer advice focused on having a positive outlook and on seeking out supportive health professionals.