Subscribe to RSS
Download PDF
DOI: 10.1055/s-0045-1802356
A Comparative Evaluation of Insulin Syringe and Prefilled Pen Usability and Preference among the Population with Diabetes in Pakistan
Funding None.
Abstract
Background
Diabetes management often requires insulin administration, and the choice of delivery method—vials/syringes or prefilled pens—significantly impacts patient adherence, satisfaction, and outcomes. While prefilled pens offer convenience and ease of use, their higher cost may limit accessibility in resource-constrained settings like Pakistan. This study evaluates the usability and patient preferences for these devices in Pakistan
Methodology
A cross-sectional observational study was conducted at the Federal Government Polyclinic Hospital Islamabad, from February 2024 to June 2024. The data were collected from the medical ward, orthopaedic ward, intensive care unit (ICU), medical ICU, and urology ward. A self-structured validated questionnaire was used to collect the demographics and knowledge assessment about the usability and preference of using an insulin pen or vial and syringe (VaS) system. Filled questionnaires were analyzed through SPSS version 26. A p-value ≤0.05 was considered significant.
Results
The study found that patients preferred insulin pens for their ease of use, convenience, and reduced risk of pain. Safety concerns, such as pain and bruising at injection sites, were reported less frequently with pens. However, traditional VaS system remained more widely used due to their affordability and accessibility. Patients expressed a willingness to switch to pens if cost barriers were addressed, highlighting the significant role of economic factors in influencing device choice.
Conclusion
This study highlights important insights into the usability and patient preferences for insulin delivery methods among diabetic patients in Pakistan. Prefilled insulin pens were generally favored for their ease of use, convenience, and potential to improve adherence, while traditional syringes were more commonly used due to affordability and accessibility. Addressing economic and systemic barriers through policy interventions, cost reduction strategies, and patient education results in optimized diabetes management.
Author Confirmation
It is hereby confirmed that the manuscript has been read and approved by all named authors and that no other persons have satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.
Data Availability Statement
The original contributions presented in the study are included in the article. Further inquiries can be directed to the corresponding author.
Ethics Statement
The research was deemed low risk and, as such, was reviewed by the Ethical Review Board of Polyclinic Hospital Islamabad and the Institutional Ethical Review Board of Quaid-i-Azam University, Islamabad.
Publication History
Article published online:
27 March 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Patil SR, Chavan AB, Patel AM, Chavan PD, Bhopale JV. A review on diabetes mellitus its types, pathophysiology, epidermiology and its global burden. J Res Appl Sci Biotechnol 2023; 2 (04) 73-79
- 2 Ogurtsova K, da Rocha Fernandes JD, Huang Y. et al. IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract 2017; 128: 40-50
- 3 Akhtar S, Nasir JA, Abbas T, Sarwar A. Diabetes in Pakistan: a systematic review and meta-analysis. Pak J Med Sci 2019; 35 (04) 1173-1178
- 4 Wallia A, Molitch ME. Insulin therapy for type 2 diabetes mellitus. JAMA 2014; 311 (22) 2315-2325
- 5 Kesavadev J, Saboo B, Krishna MB, Krishnan G. Evolution of insulin delivery devices: from syringes, pens, and pumps to DIY artificial pancreas. Diabetes Ther 2020; 11 (06) 1251-1269
- 6 Sharif S, Sharif H, Rehman J, Fatima Z. Is a sedentary lifestyle a leading causal factor of obesity and distress in type 2 diabetes? A cross-sectional study in low-socioeconomic areas of Karachi, Pakistan. BMJ Public Health 2023; 1 (01) e000149
- 7 Ramadan WH, Khreis NA, Kabbara WK. Simplicity, safety, and acceptability of insulin pen use versus the conventional vial/syringe device in patients with type 1 and type 2 diabetes mellitus in Lebanon. Patient Prefer Adherence 2015; 9: 517-528
- 8 Korytkowski M, Bell D, Jacobsen C, Suwannasari R. FlexPen Study Team. A multicenter, randomized, open-label, comparative, two-period crossover trial of preference, efficacy, and safety profiles of a prefilled, disposable pen and conventional vial/syringe for insulin injection in patients with type 1 or 2 diabetes mellitus. Clin Ther 2003; 25 (11) 2836-2848
- 9 Hansen B, Matytsina I. Insulin administration: selecting the appropriate needle and individualizing the injection technique. Expert Opin Drug Deliv 2011; 8 (10) 1395-1406
- 10 Al Hayek A, Al Dawish M. Patient-reported preference and clinical efficacy of insulin pen devices with safety needles in adolescents and young adults with type 1 diabetes: a prospective study. Cureus 2021; 13 (04) e14555
- 11 Pledger J, Hicks D, Kirkland F, Down S. Importance of injection technique in diabetes. Diabetes & Primary Care 2012; 14 (01) 53-58