Therapeutic Training Game for Children with Diabetes: A Study on Teaching Insulin Self-Injection

Background: Managing diabetes in children requires lifelong insulin therapy and learning how to inject insulin properly to keep blood sugar levels stable and avoid complications. However, many children struggle with fears, anxiety, and low confidence, which can make learning this important skill challenging. Recently, using games as a teaching tool has shown promise in making learning more engaging and supportive. This study aimed to evaluate the effectiveness of a therapeutic training game on improving insulin self-injection performance among children with diabetes and to identify the association of learning outcomes with demographic and clinical factors. Methods: An experimental study was conducted with 33 children with diabetes mellitus at Al-Sadr Medical City, Iraq. A validated insulin self-injection performance scale was administered pre- and post-training game. The training game incorporated visual, auditory, and kinesthetic learning methods, including videos, posters, and hands-on practice using dolls. Data were analyzed using SPSS version 20 and p < 0.05 was considered statistically significant. Results: The mean performance score significantly improved from 70.2 ± 7.32 pre-intervention to 86.0 ± 4.74 post- training game (p < 0.001). Higher post-training scores were associated with older age (11–13 years), middle school education, urban residence, later age at diagnosis (≥9 years), absence of injection-site pain, and regular glucose monitoring (all p < 0.05). Conclusion: The therapeutic training game significantly enhanced children’s insulin self-injection skills and promoted independence in diabetes management. Interactive, child-centered educational approaches that integrate emotional support, family involvement, and multimodal learning are recommended to improve diabetes self-care and long-term outcomes.