Supplemental Material for: Expert Recommendations on Insulin Injection Technique and Education for the Pediatric and Young Adult Population with Diabetes: FITTER Forward Youth

Considering these needs, comprehensive recommendations addressing both physiological and behavioral health aspects of YWD are warranted.</p><p dir="ltr">

Summary

Eightpediatric diabetes specialists from five countries collaborated virtually to develop pediatric and young adult recommendations for proper injection technique updated from the adult-focused Forum for Injection Technique and Therapy Expert Recommendations (FITTER) Forward guidelines published in 2025.The resulting ‘FITTER Forward Youth’ recommendations addressinsulin initiation, injection technique, storage, injection method, and lipodystrophy.

Psychosocial concerns for YWD and their caregivers, including diabetes distress, depressive symptoms, and anxiety, are also discussed. Additionally, technical and psychosocial education around insulin administration is key for YWD, their primary caregivers, and community-based secondary caregivers through daycare or school.Due tovariable resources across geographical regions and socio-economic groups, FITTER Forward Youth also encompasses proper injection technique education for manual injection devices, which are typically more accessible than advanced diabetes technologies. </p><p dir="ltr">Key Messages: This review provides updated recommendations and practical approaches for insulin delivery and diabetes education for youth and young adults with diabetes and their caregivers, addressing their unique and changingneeds.</p>