OBJECTIVES : Insulin therapy is essential for treating patients with diabetes mellitus. Early medical research indicated insulin-delivery method affected clinical and economic outcomes. The objective of this study is to explore associations between health characteristics and mode of insulin administration among patients with type II diabetes (T2DB).

METHODS : Data were obtained from the 2017 China National Health and Wellness Survey (NHWS). NHWS is an internet-based health survey, using stratified random sampling to ensure demographic representativeness of the adult urban population. Respondents self-reporting a physician-diagnosis of T2DB and use of either an insulin pen or syringe were included. Demographics, general health, mental health, and diabetes indicators were compared between pen- and syringe-users using Chi-squared test (categorical variables) and one-way ANOVA (continuous variables).

RESULTS : A total of 85 pen-users and 43 syringe-users were identified. Compared with syringe-users, pen-users were more likely to be male (68.2% vs. 30.2%), hold a university degree (44.7% vs. 20.9%), have urban employee medical insurance (61.2% vs. 16.3%), and have better mental health scores for depression (4.05±4.56 vs. 6.47±4.07 on Patient Health Questionnaire-9) and anxiety (3.02±3.25 vs. 4.30±3.13 on General Anxiety Disorder-7); all p<0.05. Meanwhile, syringe-users were more likely to have never smoked (79.1% vs. 50.6%), not drink alcohol (60.5% vs. 40%), and be classified as normal weight (67.4% vs. 49.4%); all p<0.05. Both pen- and syringe-users were equally as likely to have experienced a hypoglycemic event. Syringe-users were more likely to not know their HbA1C-level compared to pen-users (88.4% vs. 70.6%; p=0.035); however, both groups had a high proportion who did not know their HbA1C-level.

CONCLUSIONS : Pen-users had better mental health, while syringe-users had better health behaviors. Both had poor knowledge of their HbA1c-level. Physicians and pharmaceutical companies should consider both treatment efficacy and patient understanding. These results suggest further research on mode of insulin administration and treatment adherence/satisfaction are warranted.