Perceptions of Insulin Pen Use and Technique in Black and Hispanic/Latino Patients with Type 2 Diabetes: a Qualitative Study

Objectives: Non-Hispanic Blacks (NHB) and Hispanic/Latinos (H/L) are affected disproportionately by type 2 diabetes (T2DM) and its complications due to a myriad of reasons. Lack of diabetes education has been identified as one risk factor for poorly controlled diabetes. For persons using insulin, poor insulin administration technique can be problematic. Previous studies done demonstrating this have not been inclusive of NHB and H/L populations. As a result, this study aimed to use semi-structured interviews to examine insulin pen technique and training experience in NHB and H/L inpatients with T2DM. Design: Semi-structured interviews comprised open- and close-ended questions, and prompts were conducted until reaching saturation in NHB and H/L inpatients with at least 3 months of insulin pen use. Data was analyzed by two researchers who completed a thematic analysis. Results: Twenty semi-structured interviews were completed. Two major themes emerged from analysis included: patients prefer the insulin pen to syringes and vials and most had a lack of formal pen technique teaching. Conclusion: Although the insulin pen is a preferred modality of insulin delivery, this sampling of disparity patients demonstrates that insulin pen technique should be continually reassessed by health care providers as majority of the patients never had formal insulin pen teaching. Among those who did have training, they still made errors such as not priming the pen or shortened dwell time.