Enhancing Insulin Therapy Adherence Through Technology: Which Needles Do People with Diabetes Prefer?

Background: Despite major advances in insulin formulations and delivery systems since 1921, many people with diabetes (PwDs) still fail to achieve recommended glycemic targets. Common reasons include inadequate education, injection errors, and poor adherence due to factors such as needle phobia and pain. Recognition of these barriers has driven the development of improved injection systems, particularly thinner and shorter needles. An experimental study previously identified the Pic Insupen 34 G 3.5 mm needle as high performing. We therefore conducted an observational study to assess its acceptability directly among PwDs. Methods: This multicentre, open-label, real-world study enrolled 300 insulin-treated PwDs who compared their usual pen needle (30–33 G) with the new 34 G × 3.5 mm needle over two two-week periods. The primary outcome was perceived puncture pain. Results: Participants overwhelmingly preferred the 34 G needle, based on the following findings: Pain perception: 62% of 34 G users reported minimal or no pain, compared with only 8% using their previous needle. Conversely, 22% of participants reported the highest pain score with their old needle, compared with just 5% using the 34 G. Ease of use: 77% rated the 34 G needle at the highest level of ease of use, compared with 20% for their previous needle. Complications: The 34 G needle was linked to significantly fewer hypo-/hyperglycemic episodes and local skin complications such as bruising or irritation. Eighty per cent reported no glycemic fluctuations while using the 34 G needle. Robustness: Ninety-four per cent of PwDs never observed the 34 G needle bending during use, compared with 64% using their previous needle, confirming greater robustness despite its thinner profile. Conclusions: The Insupen® 34 G × 3.5 mm needle substantially reduces puncture pain and improves the overall manageability of insulin injections. Its innovative design—combining reduced thickness with optimised tip geometry—is associated with fewer complications and enhanced injection performance. Because reduced pain and ease of use are critical for improving adherence to insulin therapy, the features of the 34 G needle should inform future prescribing decisions.