More than half of all diabetics who also take insulin occasionally skip their doses, according to a new study.

Pain and embarrassment were the most common reasons given for missing an injection. Roughly 57% of respondents to the Johns Hopkins University School of Medicine and Loyola University Maryland survey reported intentionally missing a dose, while 20% reported regularly missing injections. Many times, seniors who are unaccustomed to having to take multiple medications can be overwhelmed by the change to their lifelong habits, and will miss doses, according to an opinion article accompanying the study.

Missing an insulin dose can exacerbate existing maladies, and can lead to new conditions, such as blindness and kidney failure, according to researchers. The report appears in the February issue of Diabetes Care.