Article Summary Resistance to insulin therapy among patients and providers. Peyrot M, Rubin RR, Lauritzen T, Skovlund SE, Snoek FJ, Matthews DR, et al. Diabetes Care. 2005;28:2673-2679. Objective: To describe patient and provider attitudes toward insulin therapy. Methods: Data reported are from surveys of diabetes-care providers (nurses and physicians) and patients with type 2 diabetes who are not treated with insulin in 13 countries in Asia, Australia, Europe, and North America. Results: Delaying insulin therapy was more common among US providers than in most other countries. Among opinion leaders, specialists, and those who believed insulin was efficacious, delay of insulin therapy was significantly less. Patients in the US reported lower belief in insulin efficacy than patients from all other countries. However, patients who believed in the efficacy of insulin had more diabetes-related complications and were significantly younger than those who did not believe in its efficacy. This group also reported poorer relationships with their providers. US patients described greater self-blame for a need to progress to insulin therapy than patients from all other countries, as well as significantly less exercise adherence. Conclusions: These results suggest that educational interventions should increase the patient’s knowledge of insulin efficacy. In addition, providers should avoid using insulin as a threat, instead trying to address an individual’s specific belief regarding their resistance to insulin therapy.