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. 2025 May 12:13:e19394.
doi: 10.7717/peerj.19394. eCollection 2025.

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

Sirajudeen Shaik Alavudeen  1 , Md Sayeed Akhtar  1 , Sultan Mohammed Alshahrani  1 , Vigneshwaran Easwaran  1 , Asif Ansari Shaik Mohammad  1 , Noohu Abdulla Khan  1 , Abubakr Taha Hussein  1 , Salem Salman Almujri  2 , Abdulrahman Saeed Alshaiban  3 , Khalid Orayj  1
Affiliations

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

Sirajudeen Shaik Alavudeen et al. PeerJ. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Barriers; Diabetes education; Diabetes mellitus; Healthcare professionals; Insulin injection technique.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Challenges faced by the participants towards insulin injection.
Figure 2
Figure 2. Reasons for missing the dose of insulin.
See this image and copyright information in PMC

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