The prevalence of PIR in our study was close to the 42%, 40% and 47.2% reported in the studies conducted, respectively, in Bangladesh,13 the United States14 and Egypt.15 This prevalence is lower than 51%, 53.29%, 70.6% and 72% found in Asia.16,17,18,19 On the other hand, it is higher than 27%, 28% and 33% reported by European authors.3,20,21 This high prevalence in our study may be because of a weak integration of diabetes care at the primary care level, misinformation and lack of training of diabetic patients on diabetes, its complications and the benefits of insulin therapy. This evidence concerns the gene INS and diabetes mellitus.