Unexpected Hyperglycemia? Check the Pen and Needle! An Opportunity to Prevent Injection Technique Errors and Find Causes and Possible Solutions

The clinical case presented demonstrates how a person living with type 2 diabetes and treated with insulin reuses the same pen needle several times to save money and performs an incorrect maneuver while screwing the needle, which breaks, remains stuck at the end of the pen, and causes loss of insulin during subsequent use. The findings in this case study are observed in many others in clinical practice but have only been sporadically published. Who is responsible for incorrect injections? Indeed, health workers, diabetic patients, and all the other actors involved in diabetes care and insulin utilization share responsibility. Recommendations and guidelines are not enough to fill this gap. Moreover, not all healthcare providers (HCPs) know or adhere to them. It is observed daily that more than half of insulin users make mistakes that affect glycemic control, increase the risk of complications, and reduce the quality of life of people living with diabetes, who, by a rough estimate, make up a population of over 100 million in the world. This case study offers us the opportunity to briefly review the literature on the most common errors made during insulin injection technique and, therefore, consider how necessary it is to promote structured and coordinated actions among various actors to promote the culture of therapeutic education.