ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2018
Insulin Injection Technique in China Compared with the Rest of the World.
Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 14 citations in OpenAlex.
- Pen Needle Reuse in People with Diabetes Who Inject Insulin: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Review
- Development of a Scale to Assess the Safe Disposal of Insulin Pen Needles in Patients With Diabetes: A Delphi Study.Nursing open · 2026Article
- Insulin-Related Consumables Should not be Ignored While Pooling Insulin Purchases: Experience From China.Health care science · 2025Article
- Access, awareness, and risk: drivers of unsafe sharps disposal and needle reuse in insulin-treated adults in China.Frontiers in public health · 2025Article
- Design and Testing of a Smartphone Application for Real-Time Tracking of CSII and CGM Site Rotation Compliance in Patients With Type 1 Diabetes.Journal of diabetes science and technology · 2024Article
- Fabrication and characterization of coated microneedle patches based on PEGDA for transdermal administration of metformin.Drug delivery and translational research · 2024Article
- Insulin injection knowledge, attitude and behaviour of nurses: A cross-sectional study in Guangdong Province.Nursing open · 2023Article
- Expert Opinion on Addressing the Gap in Injection Technique and Needle Reuse for People with Diabetes in Indonesia.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023Article
- Insulin Injection Knowledge, Attitudes, and Practices of Nurses in China: A Cross-Sectional Nationwide Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2021Article
- Insulin injection technique in the western region of Algeria, Tlemcen.The Pan African medical journal · 2020Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionApproximately 9 million people in China use insulin but little is known of their injection techniques (IT). Our aim was to understand IT in China via direct examination and a detailed survey.
methodsInjection Technique Questionnaire (ITQ) results of 3853 patients from 20 representative centers in China were compared with the Rest of World (ROW).
resultsInsulin pens are used by 92% of Chinese insulin injectors, with > 3/4 using 4- or 5-mm pen needles. This is consistent with Chinese BMI values (and thus subcutaneous fat thickness) being lower than in ROW, raising the risk of IM (intramuscular) injections with longer needles. Total daily insulin dose is ~ 33 IU in China vs. 45 IU elsewhere. Lipohypertrophy (LH) rates are lower than in ROW, but still found in at least 25% of Chinese patients. Patients apparently do not realize they have LH or are unaware of the hazards of injecting into LH since many of them do so, and those who do use a mean of 11 IU more of insulin than non-LH patients. This incremental insulin use possibly costs the Chinese health care service around 2 billion RMB annually. Needle reuse is also frequent in China (78% vs. 48% ROW), and the high cost of pen needles is the main reason patients cite for reusing (25% use a single needle > 10×).
conclusionThis study reveals many areas in which Chinese professionals and patients can optimize injection practices and thereby improve outcomes and reduce costs. The official guidelines of the Chinese Diabetes Society, based on the FITTER recommendations, offer a roadmap for reaching this goal.
fundingBD Diabetes Care. Plain language summary available for this article.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.