Perceptions of Insulin Pen Use and Technique in Black and Hispanic/Latino Patients with Type 2 Diabetes: a Qualitative S
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Perceptions of Insulin Pen Use and Technique in Black and Hispanic/Latino Patients with Type 2 Diabetes: a Qualitative Study A. K. Myers 1,2,3,4
&
N. Gulati 1 & B. Pascarelli 5 & K. Finuf 5 & A. L. Hahn 6 & A. B. Bissoonauth 4,7 & R. Pekmezaris 3,4,5
Received: 9 October 2019 / Revised: 9 October 2019 / Accepted: 2 February 2020 # W. Montague Cobb-NMA Health Institute 2020
Abstract Objectives Non-Hispanic Blacks (NHB) and Hispanic/Latinos (H/L) are affected disproportionately by type 2 diabetes (T2DM) and its complications due to a myriad of reasons. Lack of diabetes education has been identified as one risk factor for poorly controlled diabetes. For persons using insulin, poor insulin administration technique can be problematic. Previous studies done demonstrating this have not been inclusive of NHB and H/L populations. As a result, this study aimed to use semi-structured interviews to examine insulin pen technique and training experience in NHB and H/L inpatients with T2DM. Design Semi-structured interviews comprised open- and close-ended questions, and prompts were conducted until reaching saturation in NHB and H/L inpatients with at least 3 months of insulin pen use. Data was analyzed by two researchers who completed a thematic analysis. Results Twenty semi-structured interviews were completed. Two major themes emerged from analysis included: patients prefer the insulin pen to syringes and vials and most had a lack of formal pen technique teaching. Conclusion Although the insulin pen is a preferred modality of insulin delivery, this sampling of disparity patients demonstrates that insulin pen technique should be continually reassessed by health care providers as majority of the patients never had formal insulin pen teaching. Among those who did have training, they still made errors such as not priming the pen or shortened dwell time. Keywords Black . Hispanic . Latino . Type 2 diabetes . Insulin pen
Introduction Non-Hispanic Black (NHB) and Hispanic/Latino (H/L) persons have a disproportionate burden of diabetes in the USA as they are both groups that are nearly twice as likely to be diagnosed with diabetes when compared with non-Hispanic whites (NHW) [1]. NHB and H/L are also more likely to be diagnosed with diabetic complications including end-stage renal disease (ESRD) and limb amputations when compared
* A. K. Myers [email protected] 1
Department of Internal Medicine, Division of Endocrinology, North Shore University Hospital, Manhasset, NY, USA
2
Center for Health Outcomes and Innovations Research, Northwell Health, Manhasset, NY, USA
3
David and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
with NHW [2, 3]. There is a myriad of biological, social, and environmental reasons which can explain these disparities. On a biological level, NHB have greater rates of sickle cell disease which can falsely elevate or lower the measure of glycemic control: hemoglobin A1c (HbA1c) due to its abnormal configuration [3]. In addition, NHB and Mexican-American women have the highes
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