Incorrect Insulin Administration: A Problem That Warrants Attention
Open accessAbstract
In Brief Incorrect administration of insulin (e.g., too little, too much, or at wrong times) can result in transient and serious hypo- and hyperglycemia, wide glycemic excursions, and diabetic ketoacidosis. The authors systematically assessed the insulin-related knowledge and injection skills of a sample of adults with diabetes and found that errors in self-administering insulin, including choosing an incorrect insulin dose, were common. Injection site selection and diabetes numeracy were also concerns. Correct timing of injections and confidence in choosing correct doses, but not skills scores, related to better A1C and blood glucose levels.
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In most populations, approximately 20-30% of those with type 2 diabetes mellitus are taking insulin.
“In most populations, approximately 20–30% of those with T2DM are taking insulin27,28.”
From The epidemiology of type 1 diabetes mellitus in older adults (2025) · cites this paper as [28]
The Abstract reports that approximately 31% of diabetes patients are treated with insulin, which is close to the claimed range. It does not give a 20–30% estimate specifically for people with type 2 diabetes or establish that the estimate holds in most populations. (LLM, conf=0.86)
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Cites
Correlates of Insulin Injection Omission
Peyrot, M., Rubin, R. R., Kruger, D. F., & Travis, L. B. (2010) · Diabetes Care · doi:10.2337/dc09-1348 · Cited by 407 · see citing works
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Missed and Mistimed Insulin Doses in People with Diabetes: A Systematic Literature Review
Robinson, S., Newson, R. S., Liao, B., Kennedy-Martin, T., & Battelino, T. (2021) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2021.0164 · Cited by 73 · see citing works
The epidemiology of type 1 diabetes mellitus in older adults
Tomic, D., Harding, J. L., Jenkins, A. J., Shaw, J. E., & Magliano, D. J. (2025) · Nature Reviews Endocrinology · doi:10.1038/s41574-024-01046-z · Cited by 58 · see citing works
“In most populations, approximately 20–30% of those with T2DM are taking insulin 27,28 .”
Diaz C., J. L., Fabris, C., Breton, M. D., & Cengiz, E. (2022) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2022.0154 · Cited by 19 · see citing works
A Roadmap to an Equitable Digital Diabetes Ecosystem
Kerr, D., Klonoff, D. C., Bergenstal, R. M., Choudhary, P., & Ji, L. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2022.12.016 · Cited by 10 · see citing works
Lim, D., & Woo, K. (2025) · Geriatric Nursing · doi:10.1016/j.gerinurse.2024.11.014 · Cited by 8 · see citing works
- Authors
- Trief, P. M., Cibula, D., Rodriguez, E., Akel, B., & Weinstock, R. S.
- Affiliations
- State University of New York (US)
- SUNY Upstate Medical University (US)
- Corresponding author
- Trief, Paula M.
- Venue
- Clinical Diabetes
- Publisher
- American Diabetes Association
- Published
- 2016-01-01
- Volume
- 34
- Issue
- 1
- Pages
- 25-33
- ISSN
- 0891-8929 (ISSN-L)
- 1945-4953
- PMC
- PMC4714726
- OpenAlex
- W2242208213
- Cited by
- 69
- References
- 1
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 14 · 2023: 9 · 2022: 15 · 2021: 7 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 1
- FWCI
- 3.35
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Diabetes (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- insulin administration errors, self-injection, hypoglycemia, hyperglycemia, diabetic ketoacidosis, injection site selection, injection timing, HbA1c, diabetes self-management
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