What question did this study set out to answer?

To investigate insulin injection practices among community-dwelling diabetes patients and implement quality management programs based on findings.

May 3, 2026Open Access

Effectiveness of a structured special quality management program on insulin injection practices among community-dwelling patients with diabetes in a county district: a pre-post intervention study

XLXuehang LouFuyang Maternity and Child Health Care Hospital 吴吴旭丹Fuyang Maternity and Child Health Care Hospital SJSha JiaFuyang Maternity and Child Health Care Hospital

Key Points

To investigate insulin injection practices among community-dwelling diabetes patients and implement quality management programs based on findings.
One-group pre-post study design with 297 randomly selected patients receiving insulin injections.
Implemented a structured quality management program including health education and standardized training.
Follow-up evaluation conducted 6 months post-intervention to assess sustainability of the effects.
Knowledge and operational levels concerning insulin improved significantly (p < 0.05).
HbA1c levels decreased from 7.13% at baseline to 5.93% post-intervention, with a mean reduction of 1.20% (95% CI: 0.98–1.42%, t = 10.54, p < 0.001).
Improvements in injection practices and diabetes management were sustained over time.

Abstract

Objective To investigate the current status of insulin injection among patients with diabetes in a county-level community through questionnaires and to implement a targeted special quality management (QM) program based on the findings. Methods Using a one-group pre-post study design, 297 patients receiving insulin injections were randomly selected from the local community’s chronic disease management database. A baseline insulin injection-related questionnaire survey was conducted. A multidisciplinary collaborative management team (MCMT) was established to analyze the results and implement a structured special QM program. The team developed an insulin injection quality evaluation system and carried out interventions including systematic health education, standardized operation training, and regular quality supervision with feedback. After a one-year QM period, a second questionnaire survey was administered. To assess the sustainability of the intervention effects, a follow-up evaluation was conducted 6 months after the completion of the QM program (i.e., at 18 months from baseline), using the same questionnaire and HbA1c measurement. These data will be reported in a subsequent analysis to determine whether improvements in knowledge, injection practices, and glycemic control were maintained over time. Baseline data were also indirectly compared with recent international Insulin Injection Technique Questionnaire (ITQ) data for contextualization. Results After the QM intervention, significant improvements were observed in knowledge and operational levels concerning diabetes, insulin, insulin storage, and insulin injection ( p 0.05). Glycated hemoglobin (HbA1c) levels decreased from 7.13% (SD = 1.74%) at baseline to 5.93% (SD = 1.00%) post-intervention, with a mean reduction of 1.20% (95% CI, 0.98–1.42%, t = 10.54, p 0.001), indicating a statistically and clinically significant improvement. Conclusion Addressing insulin injection problems identified in the county community through establishing a targeted special QM program is beneficial for improving diabetes control and management at the community level.

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