# A cross-sectional study evaluating insulin injection techniques and the impact of instructions from various healthcare professionals on insulin users in the southern region of Saudi Arabia

## TL;DR

This study examines insulin injection techniques and how education from healthcare professionals affects their effectiveness in Saudi Arabia.

## Contribution

The study highlights the impact of diabetes education specialists on proper insulin injection techniques and identifies common challenges faced by users.

## Key findings

- Only 36% of participants educated by diabetes educators demonstrated proper insulin injection techniques.
- Common challenges include managing insulin while traveling and timely injections.
- Forgetfulness and routine changes are leading reasons for missed insulin doses.

## Abstract

It is evident that proper use of the insulin injection technique (IIT) is important for optimizing the efficacy of the therapy. Despite the readily available manufacturers’ instructions, healthcare professionals (HCPs) play a major role in educating patients. This study aims to investigate the knowledge, practices, and challenges faced by insulin users regarding IIT, as well as the impact of healthcare professionals’ education on it.

We conducted a questionnaire-based cross-sectional study using a validated online questionnaire to gather demographic and clinical data, as well as the participants’ knowledge, practices, and challenges related to insulin therapy.

The mean age of the participants was 38.25 ± 15.58 (mean ± SD) years, with a nearly equal distribution of genders. Thirty-six percent of the participants educated by the diabetes educators demonstrated an appropriate IIT, such as storage, priming the insulin pen (54%), skin folding (63%), injection hold time, and “use-by” date. Furthermore, the absence of diabetes education specialist training increases the likelihood of errors, potentially leading to a loss of glycemic control. Patients reported carrying insulin when traveling as one of the major challenges (27.9%), followed by timely injections (23.7%), priming (21.6%), and adjusting the insulin dose (16.8%). Forgetfulness (47.7%), traveling or altering the regular routine (15.5%), missing a meal (15.5%), and being overly busy (13.5%) were among the reasons for missing the insulin dose; all of which are easily manageable with proper education.

Consistent education and re-education are necessary for the insulin users to resolve the issues associated with suboptimal IIT. The inclusion of all stakeholders in insulin therapy, particularly the diabetes education specialists, is essential. Therefore, the Ministry of Health in Saudi Arabia should take the initiative to ensure that appropriately trained diabetes education specialists, pharmacists, nurses and other HCPs assess and follow up on patients.