Both preventive and therapeutic interventions are necessary for good diabetes management and the prevention of complications. There are serious therapeutic and financial repercussions when patients don't follow their doctors' orders about medicine, nutrition, and healthcare procedures. The current comprehensive review aims to determine factors that have been observed in patients with type 2 diabetes and low health literacy, contribute to poor treatment adherence in 2022. Five steps were taken to complete this review: creating a research question, looking for and extracting relevant papers, choosing relevant studies, tabulating data, and reporting findings. Using the terms "Type 2 diabetes", "obstacles", "determinants", "factors", "barriers", "treatment", "medication", "therapy" "adherence", "non-adherence", "poor adherence", and "low health literacy" was gathered from six electronic databases (Scopus, Web of Science, Embase, Science Direct, PubMed and Google Scholar) from January 2018 to January 2022. Twelve were able to be reviewed from the initial 140 articles. In this review, ten studies have been selected involving 1497 patients with type 2 diabetes. The range of nonadherence prevalence was from 42% to 74.3%. Economic difficulties, inadequate communication with the medical staff, an absence of family support, ignorance, misinterpretation, and low health literacy were major barriers to treatment adherence in the publications. The findings of this study identified both modifiable and non-modifiable factors influencing medication adherence in type 2 diabetes patients. Modifiable factors must be addressed by suitable interventions carried out with the target population and healthcare experts. Manuscript profile

Due to the progressive nature of type 2 diabetes mellitus (T2DM), insulin therapy will almost always be needed to maintain appropriate glycemic control in the majority of patients. Insulin therapy is unfortunately not implemented right away. Beginning insulin therapy is made more difficult by a number of patient misconceptions and erroneous ideas. To study the barriers and perceptions to insulin therapy in type 2 diabetes patients from their perspective. A descriptive cross-sectional study was conducted from March – September 2023 among 220 type 2 diabetes mellitus patients presenting in the endocrine outpatient department (OPD) at a tertiary healthcare center. A questionnaire inquiring about demographic characteristics, the status of insulin therapy, barriers to insulin therapy, and knowledge about insulin therapy for T2DM was administered during face-to-face interviews. Results: The study included 220 participants; the majority were from the age group 45–60 years (62.72%), females (50.90%), illiterate (20.90%), employed (58.18%), monthly income above 5000 (89.09%), duration of treatment with 2 or more drugs above 5 years (80.90%), and less than 10 years of insulin added to the treatment regimen (67.72%). The commonest barrier to insulin therapy is that it can cause blindness, cardiac arrest, and amputation, followed by a negative impact on working efficiency (70%). Seventy percent thought that insulin had a negative impact on social relationships and a fear of injection. Regarding the use of insulin, patients have a variety of worries and attitudes. Lack of knowledge about the benefits and adverse effects of using insulin, as well as misconceptions about these topics, appear to be important deterrents for diabetes patients from initiating this therapy. Manuscript profile