Insulin Injection Technique Education and Associated Knowledge Factors Among Physicians: Cross-Sectional Survey Study

Insulin therapy is crucial for managing type 2 diabetes mellitus, with its use steadily increasing in Indonesia and its effectiveness well established. However, prescribing insulin poses various challenges that can impact the effectiveness of insulin. Patient education is crucial for the successful implementation of insulin therapy. Proper insulin use remains insufficient in Indonesia.

This study aims to investigate physicians' knowledge and practice in providing education on insulin use to patients with type 2 diabetes mellitus in Indonesia.

This study recruited potential participants (all physicians in Indonesia) through the internet using a convenience sampling method. The participants were asked to fill out a questionnaire. The questionnaire had 32 questions divided into 4 sections: demographics and clinical practice, practice of insulin education, the Indonesian insulin injection technique guideline, and knowledge of insulin injection techniques. The instrument used in this study was developed based on the Pedoman Teknik Menyuntik Insulin Indonesia, which was adapted from the international consensus by the Forum for Injection Technique and Therapy Expert Recommendations. The survey lasted from February 2021 to March 2021. Data were analyzed using the Kruskal-Wallis tests.

A total of 823 participants were included in the analysis. Out of 823 participants, 680 (82.6%) had given insulin education to patients at least once during the last 30 days. However, out of 823 participants, only 479 (58.2%) used specific guidelines in their practice, with only 280 (34.0%) aware of the Indonesian guidelines. Out of 823 participants, 815 (99.1%) agreed that insulin injection techniques would affect clinical results. The median score of knowledge about insulin injection techniques was 7 (IQR 2) among the study participants, indicating good knowledge. Profession was the only variable significantly associated with knowledge scores, with consultants in endocrinology, metabolism, and diabetes achieving the highest median scores, and other physicians the lowest (P<.001).

Most physicians in this study reported providing education to their patients. However, there was still a gap between the guidelines and the practice of insulin education, as indicated by the lack of awareness and a fair level of knowledge about the Indonesian guidelines.