Date of Award

Spring 5-31-2020

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Razel Milo phD, DNP, MSN, FNP-C, RN


Title: Insulin Injection Re-education for Improved Glycemic Control

Background: Patients on insulin therapy often continue to show suboptimal glycemic control. Data from adult patients with T2DM have demonstrated that 56.1% had poor control, despite adherence to treatment, oral and injectable. Poor glycemic control stems from many sources, including poor self-efficacy regarding insulin dosage adjustment, inaccurate insulin dosing, expired insulin, lipohypertrophy of the injection site and technique, and equipment issues.

Purpose: This project aimed to implement and assess the efficacy of re-education in the insulin injection technique for improved glycemic control.

Methods: This project was conducted based on the John Hopkins Nursing Evidence-Based Practice Model. Patients were asked to complete a short survey to evaluate their baseline knowledge. Then, correct answers were given and a short 10 minutes re-education instruction session happened over the phone, and with written materials. Written materials were sent in by mail. Follow up happened monthly over the phone. The latest HbA1C levels will be used as a baseline and then re-measured three months after the instruction session was conducted.

Results: Pre- intervention A1C average was 8.7, and it was dropped to 7.5 at the post-intervention A1C.

Conclusion: There is a knowledge gap among patients self-administering insulin and other injectables; healthcare providers must be assessing their knowledge and provide refreshers periodically.