Evidence map›Paper›PMID 41735759›Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2026

Insulin Pen Needle Reuse in U.S. Adults with Diabetes: A Cross-Sectional Survey Study on Patterns, Motivations, and Educational Implications.

Susan Guzman, Natalie Bellini, Lucille Hughes, Pasha Javadi, Camilla Schanche, Maria Muccioli, Lori Berard

Abstract read
In one paragraph

Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Pen Needle Reuse in People with Diabetes Who Inject Insulin: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Susan GuzmanBehavioral Diabetes Institute, 7220 Trade Street Shite 115, San Diego, CA, 92121, USA. sjg@behavioraldiabetes.org.ORCID http://orcid.org/0000-0001-5286-0705
Natalie BelliniCase Western Reserve University, Cleveland, OH, USA.ORCID http://orcid.org/0009-0005-4439-7374
Lucille HughesEmbecta, Parsippany, NJ, USA.ORCID http://orcid.org/0009-0009-9426-5723
Pasha JavadiEmbecta, Parsippany, NJ, USA.ORCID http://orcid.org/0000-0003-1711-2343
Camilla SchancheThrivable, Fuquay-Varina, NC, USA.ORCID http://orcid.org/0000-0001-8369-5853
Maria MuccioliThrivable, Deland, FL, USA.ORCID http://orcid.org/0009-0001-7029-0029
Lori BerardNurse Consultant, Winnipeg, Winnipeg MB Canada, Canada.ORCID http://orcid.org/0000-0002-9695-2094

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEffective insulin therapy relies on proper injection technique and the correct use of insulin delivery devices. Despite recommendations for a single-use device, the pen needle reuse remains common. This study explored pen needle reuse patterns, reasons for reuse, and motivators to changing reuse behavior, in order to provide actionable insights for clinical education and patient-support interventions.

methodsA cross-sectional online survey was conducted with 500 U.S. adults with type 1 diabetes (T1D) or type 2 diabetes (T2D) who inject insulin at least twice daily using an insulin pen and use insulin pen needles at least twice before replacing.

resultsApproximately 70% of survey participants reported using needles 2-5 times before replacing, and about 30% used them six or more times, with higher reuse among participants with T1D. Despite most participants reporting initial insulin injection education (86.8%), the majority indicated limited follow-up regarding injection practices. Specifically, 73.6% indicated their injection sites were never examined by a healthcare professional (HCP), 72.8% reported their injection technique had never been reviewed, and 66.2% reported their HCP had never asked them about injection site problems. The main reported reasons for needle reuse include convenience (64.2%), habit (46.2%), environmental/waste concern (40.8%), and cost (40.6%). The most motivating educational messages for changing reuse include those around A1c improvement and lipohypertrophy prevention, with the most trusted sources of information being endocrinologists, followed by primary care physicians (PCP), diabetes educators (known in the U.S. as diabetes care and education specialists), and peers.

conclusionsPen needle reuse is widespread and initial education alone is insufficient. Ongoing reinforcement and messaging from trusted HCPs, particularly around A1c and injection-site outcomes, provide a key opportunity to support behavior change.

Indexed as

Diabetes educationInsulinNeedle reusePen needleType 1 diabetesType 2 diabetes

Identifiers

PMID41735759
PMCPMC13103160

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Registered trials

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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.