Introduction: This survey studied the knowledge and/or practices of drug injection techniques of diabetes patients, nurses, and physicians to guide formulating national standardized diabetes drug injection guidelines.

Methods: Patients, nurses, and physicians were recruited from 259 primary, 150 secondary, and 100 tertiary care hospitals chosen using stratified cluster sampling. Their knowledge and/or practices of drug injection techniques were surveyed using the Diabetes Drug Injection Knowledge and Practice Questionnaire for Physicians, Nurses and Patients.

Results: Totally 10694, 2643 and 2816 eligible questionnaires were collected from diabetes patients (92.3% type 2 diabetes) , physicians and nurses, respectively. Needlestick injury occurred in 13.0% patients, 19.8% patients had hypoglycemic episodes and 54.5% patients failed to attain the target HbA1c. Care setting and injection practice were significant determinants of needlestick injury, hypoglycemia and target HbA1c attainment. Overall, 48.9% physicians and 20.4% nurses had a poor knowledge domain score. Care setting, training, and diabetes care experience were significant determinants of diabetes drug injection knowledge domain scores in both physicians and nurses. Furthermore, >92% of the nurses properly performed the steps of injecting diabetes drugs. Needle injury occurred in 24.0% nurses. Care setting, nurse professional levels, and diabetes care experience were significant determinants of needlestick injury.

Conclusions: This nationwide survey offers insights into diabetes drug injection knowledge and practices in China and provides evidence for drafting nationwide guidelines for diabetes drug injection techniques.


L.Guo: None. Q.Ji: None. S.Jiang: None. D.Liu: None. J.Liu: None. X.Ran: None. Y.Xue: None. Q.Zhang: None.

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