Correlates of Insulin Injection Omission
Open accessAbstract
OBJECTIVE: The purpose of this study was to assess factors associated with patient frequency of intentionally skipping insulin injections. RESEARCH DESIGN AND METHODS: Data were obtained through an Internet survey of 502 U.S. adults self-identified as taking insulin by injection to treat type 1 or type 2 diabetes. Multiple regression analysis assessed independent associations of various demographic, disease, and injection-specific factors with insulin omission. RESULTS: Intentional insulin omission was reported by more than half of respondents; regular omission was reported by 20%. Significant independent risk factors for insulin omission were younger age, lower income and higher education, type 2 diabetes, not following a healthy diet, taking more daily injections, interference of injections with daily activities, and injection pain and embarrassment. Risk factors differed between type 1 and type 2 diabetic patients, with diet nonadherence more prominent in type 1 diabetes and age, education, income, pain, and embarrassment more prominent in type 2 diabetes. CONCLUSIONS: Whereas most patients did not report regular intentional omission of insulin injections, a substantial number did. Our findings suggest that it is important to identify patients who intentionally omit insulin and be aware of the potential risk factors identified here. For patients who report injection-related problems (interference with daily activities, injection pain, and embarrassment), providers should consider recommending strategies and tools for addressing these problems to increase adherence to prescribed insulin regimens. This could improve clinical outcomes.
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This was the first study to investigate the effects of missed basal insulin injections using accurate injection data from a smart insulin pen.
“The present study was the first to investigate the effects of missed basal insulin injections using accurate injection data from a smart insulin pen; previous studies using data from smart insulin pens have primarily focused on missed bolus insulin doses.4,8”
From Smart Pen Exposes Missed Basal Insulin Injections and Reveals the Impact on Glycemic Control in Adults With Type 1 Diabetes (2024) · cites this paper as [8]
The citation supports the sentence’s characterization of previous studies as using smart-pen data and focusing on missed bolus doses, not its claim about the citing authors’ present study. This paper instead used an Internet survey of self-reported injection omission (Research Design and Methods) and explicitly says it had no objective measure of insulin use (Conclusions, Study strengths and limitations). It therefore cannot serve as an example of a prior study using smart-pen injection data. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredPrevious studies using data from smart insulin pens have primarily focused on missed bolus insulin doses.
“The present study was the first to investigate the effects of missed basal insulin injections using accurate injection data from a smart insulin pen; previous studies using data from smart insulin pens have primarily focused on missed bolus insulin doses.4,8”
From Smart Pen Exposes Missed Basal Insulin Injections and Reveals the Impact on Glycemic Control in Adults With Type 1 Diabetes (2024) · cites this paper as [8]
The Research Design and Methods section describes an Internet survey, and Study strengths and limitations says the study had no objective measure of insulin use. Searches for smart insulin pens, missed bolus doses, and basal injections found no passage addressing what earlier smart-pen studies primarily examined. (LLM, conf=0.78)
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- Authors
- Peyrot, M., Rubin, R. R., Kruger, D. F., & Travis, L. B.
- Affiliations
- Johns Hopkins University (US)
- Henry Ford Health (US)
- The University of Texas Medical Branch at Galveston (US)
- Corresponding author
- Peyrot, Mark
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2010-02-01
- Volume
- 33
- Issue
- 2
- Pages
- 240-245
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2809256
- OpenAlex
- W2103829708
- Cited by
- 407
- References
- 24
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 17 · 2023: 18 · 2022: 18 · 2021: 17 · 2020: 21 · 2019: 30 · 2018: 33 · 2017: 31 · 2016: 38 · 2015: 29 · 2014: 33 · 2013: 37 · 2012: 22
- FWCI
- 22.33
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- insulin omission, insulin injection, type 1 diabetes, type 2 diabetes, insulin adherence, injection pain, socioeconomic factors, age, insulin regimens
- MeSH terms
- Adult, Aged, Behavior, Cardiovascular Diseases, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Ethnicity, Female, Health Surveys, Humans, Hypertension, Hypoglycemic Agents, Income, Insulin, Male, Middle Aged, Perception, Regression Analysis, Risk-Taking, Self Care, Racial Groups
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