To understand the status quo and problems of insulin application at home in patients with diabetes mellitus.

Pharmacists in many hospitals across the country were organized to conduct a questionnaire survey on status quo of insulin application in patients with diabetic mellitus, so as to understand their insulin use, insulin injection behavior, insulin treatment adherence, glucose monitoring adherence, insulin preservation behavior, rate of up to target blood glucose, and the incidence of adverse reactions such as hypoglycemia. The questionnaire contained 50 questions, the accuracy rate of 21 questions related to insulin application norms was calculated, and the effect of insulin application behavior of patients on the efficacy and safety of insulin therapy was investigated.

Clinical pharmacists from 31 hospitals across the country participated in the questionnaire distribution and survey, and 240 valid questionnaires were returned. Among the 240 patients, 106 (44.2%) were male and 134 (55.8%) were female, aged (58±15) years; 210 (87.5%) had type 2 diabetes mellitus, 25 (10.4%) had type 1 diabetes mellitus, and 5 (2.1%) had other types; 151 (62.9%) patients were treated with one kind of insulin, 89 (37.1%) were treated with 2 kinds of insulin, and a total of 13 kinds of insulin were involved; 97.9% (235/240) of the patients had at least one wrong or irregular insulin use behavior, 75.0% (180/240) had at least one problem related to insulin treatment adherence, 70.4% (169/240) had poor glucose monitoring adherence, and 68.8% (165/240) had at least one irregular insulin preservation behavior. The rate of up to target blood glucose was only 13.8% (33/240), and the incidence of hypoglycemia was 55.8% (134/240). The total correct rates of answers to insulin use behavior and treatment adherence in patients with up to target blood glucose were significantly higher than those in patients without up to target blood glucose [71.4% (57.1%, 81.0%) vs. 61.9% (52.4%, 71.4%), P=0.045; 77.8% (55.6%, 88.9%) vs. 66.7% (55.6%, 77.8%), P=0.023], and differences in the correct rate of answers to insulin use behavior and each behavior between the patients with and without hypoglycemia were not statistically significant (all P>0.05).

Insulin has a wide variety and similar drug names, which are easily confused, leading to medication errors. The incidence of irregular insulin injection behavior, treatment adherence, and insulin preservation behavior in patients is high, which may affect the rate of up to target blood glucose.

Diabetes mellitus; Insulin; High-alert medications; Health knowledge, attitudes, practice; Surveys and questionnaires