Knowledge, attitudes, and practices on insulin among community pharmacists in Turkey

Diabetes management increasingly depends on the effective use of insulin, with community pharmacists playing a key role in ensuring proper patient counseling. However, evidence on the readiness of Turkish pharmacists to support insulin therapy remains limited. This cross-sectional study evaluated the knowledge, attitudes, and practices (KAP) of Turkish community pharmacists through a validated survey conducted between November 2024 and April 2025 among 385 pharmacists. The questionnaire included demographic data and 35 items assessing insulin-related KAP. Data were analyzed using descriptive statistics, Chi-square, ANOVA, correlation, and simple linear regression tests.Overall knowledge was acceptable (mean = 14.239, p < 0.001), with only 25.2% achieving a "good" level, while notable gaps remained in hypoglycemia recognition and diabetic ketoacidosis management. Age was a significant factor: younger pharmacists (20–40 years) scored highest, while those aged ≥61 scored lowest, with none classified as "good" (F = 33.683, p < 0.001). These generational differences reflect the effect of updated curricula and emphasize the need for ongoing education.Attitudes were generally neutral to positive (mean = 3.375, p < 0.001), highlighting insulin's effectiveness and patient education, though empathy and economic aspects were weaker. Practices were moderate to good (mean = 3.85, p < 0.001), with higher confidence in storage and administration than in complication management. Weak but significant correlations were found between knowledge, attitudes, and practices, suggesting knowledge alone is insufficient to shape behavior. In conclusion, younger pharmacists demonstrated better knowledge, underscoring the importance of lifelong learning to maintain consistent counseling and improve diabetes care. Keywords: community pharmacists, insulin, diabetes mellitus, KAP, Turkey, pharmaceutical practice