Research Article Insulin Knowledge, Handling, and Storage among Diabetic Pilgrims during the Hajj Mass Gathering Saber Yezli , 1 Yara Yassin , 1 Abdulaziz Mushi , 1 Bander Balkhi , 2 and Anas Khan 1,3 1 The Global Centre for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia 2 Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia 3 Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia Correspondence should be addressed to Saber Yezli; saber.yezli@gmail.com Received 1 March 2021; Accepted 18 May 2021; Published 29 May 2021 Academic Editor: Andrea Scaramuzza Copyright © 2021 Saber Yezli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Diabetes is one of the most common underlying health conditions among Hajj pilgrims. Many diabetics manage their condition using insulin, which requires appropriate storage conditions to maintain its stability and effectiveness. We aimed to investigate insulin knowledge, storage, and handling among diabetic pilgrims during Hajj to identify specific areas for improvement. Method. Adult diabetic pilgrims from 22 countries were interviewed using a structured questionnaire during the 2019 Hajj. Results. The study enrolled 277 diabetic pilgrims with a mean age of 58.4 years (SD = 10:4, range: 20-83) and male : female ratio of 1.6 : 1. Most participants (86.4%) were literate and reported using insulin for a mean of 7.1 years (SD = 5:3, range: 1-23). Over 95% of pilgrims brought their insulin with them from their country of origin, where they also received most of their insulin storage information, mainly from physicians (77.8%) and pharmacists (59.6%). Pilgrims’ knowledge regarding insulin storage was just above average (mean knowledge score = 0:51; SD = 0:23). Pilgrims who were literate and previously received education on insulin storage, those with a higher level of education, and those with a longer duration of insulin therapy, had significantly higher knowledge scores. Pilgrims’ storage and handling of their insulin during Hajj also varied depending on the stages of their pilgrimage journey. Conclusion. Inadequate knowledge and inappropriate practices regarding insulin handling and storage were identified among diabetic Hajj pilgrims, which could compromise the quality of insulin and lead to health hazards. Improving diabetic pilgrims’ knowledge of diabetes management, including insulin storage, will be beneficial during the pilgrimage and beyond. 1. Introduction With an estimated global prevalence of 9.3% in 2019, diabe- tes is a significant global public health issue, responsible for sizeable mortality and morbidity worldwide and causing a substantial economic loss [1, 2]. The disease resulted in an estimated 1.37 million deaths in 2017 and cost an estimated US$1.31 trillion in 2015 [1, 3]. Diabetes can lead to kidney failure, blindness, and lower limb amputation and has also emerged as a leading cause of disability globally [4]. Poor gly- cemic control is a major risk factor for the development of diabetes complications and mortality and is directly linked to higher total healthcare, hospitalization, and medication costs [5, 6]. The management of diabetes is based on both medications and lifestyle modifications to achieve and main- tain optimal glycemic control. Despite evidence that good diabetes management and glycemic control reduce microvas- cular and macrovascular complications [7], poor glycemic control is common among diabetics [8–11]. Although many diabetic patients use insulin therapy to manage their condition, lack of knowledge of the therapy and appropriate use of insulin is common and can lead to poor outcomes. Factors such as lack of adherence to therapy, incorrect insulin administration techniques, poor quality of insulin, inadequate insulin dose, and improper storage of the medication have been linked to poor glycemic control among diabetics [9–13]. Insulin is a labile drug, sensitive to extreme temperatures, sunlight, and shaking and hence needs to be appropriately handled and stored to be effective. Thus, insulin needs to be stored in refrigerators at 2-8 ° C (not Hindawi Journal of Diabetes Research Volume 2021, Article ID 5596914, 8 pages https://doi.org/10.1155/2021/5596914