scholarly journals The injection technique: results of a questionnaire study of diabetic patients in Russia. New international guidelines on the injectiontechnique

2010 ◽  
Vol 13 (3) ◽  
pp. 38-44 ◽  
Author(s):  
Olga Georgievna Mel'nikova ◽  
Alexander Yur'evich Mayorov
Keyword(s):  
Hba1c Level ◽  
Anterior Abdominal Wall ◽  
Insulin Injection ◽  
Injection Therapy ◽  
Injection Technique ◽  
Diabetic Patients ◽  
Needle Length ◽  
Technical Aspects

Aim. To consider technical aspects of antihyperglycemic injection therapy in patients with type 1 and type 2 diabetes mellitus.Methods. The analysis included 200 adult patients (60 men and 140 women) receiving injection therapy for at least 6 months. They filled a 40-iremquestionnaire designed to estimate socio-demographic parameters, the use of different devices for insulin injection, and the most frequent mistakesmade by the patients. Their mean age was 51.7?15.1 years, duration of DM 11.9?9.1 years, mean HbA1c level 8.4?1.5%. Results. 130 (65%) patients used semiautomated injection pens, 39 (19.5%) disposable syringes, 31 (15.5%) both devices. Most patients (122, 61%)used 8 mm needles, 32 (16%) used 12.7 mm needles, 31 (15.5%) 10 mm, 28 (14%) 12 mm, 19 (9.5%) 6 mm, 18 (9.0%) 5 mm. 64 (32%) patientsused needles of different length, 25 (12.5%) could not give a definitive information about the needle length they used. Location of injection sites variedconsiderably in individual patients. 87 (43.5%) made injections within a single anatomic regions (62 into the anterior abdominal wall, 19 into theanterolateral surface of the thigh, 5 into shoulders, and 1 into buttocks. 113 (56.5%) patients made injections into two or more regions. 83 (41.5%)developed lipodystrophy at injection sites, 42 (50.6%) continued to use them for injections (12 did it on a regular basis and 30 occasionally). HbA1clevels were 9.5 and 8.2% in patients who made injections into affected sites and who had no lipodystrophic changes respectively (p=0.02). Over halfof the interviewed patients (106 or 53%) were informed about correct subcutaneous injection technique by the attending endocrinologist, 60 (30%)were taught by the nursing staff while staying in a hospital or visiting an endocrinological dispensary, 28 (14.%) were educated at Diabetes schools,9 (4.5%) when seeing the local therapist, and 19 (9.5%) by non-professionals. Conclusion. Many patients make serious mistakes when self-administering insulin. Incompliance with the guidelines on insulin injections leading tothe impairment of carbohydrate metabolism, the technical aspects of injections must be in the focus of attention of any practitioner. New (2010) internationalguidelines on the injection technique are overviewed.

scholarly journals Insulin Injection Technique is Negatively Correlate to Short- and Long-run Glycemic Control in Type 2 Diabetic Patients with Long-Acting Insulin Analogue

2021 ◽  
Author(s):  
Yan Cheng ◽  
Qing-he Li ◽  
Fen-di Yi ◽  
Li-ping Chen ◽  
Lei Yuan ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Insulin Analogue ◽  
Insulin Injection ◽  
Injection Technique ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Acting Insulin ◽  
Long Run ◽  
Long Acting

Abstract Objective: To observe the effects of insulin injection technique (IT) on short- or long-run glycemic control in type 2 diabetic patients (T2D) with long-acting insulin analogue. Methods: This was a single-center, cross-over, observational and open-labled study. Patients with T2D receiving long-acting insulin analogue insulin were enrolled as inpatients. The study period lasting for 5 days including a 1-day screen period and 4-day continuous glucose monitoring (CGM) period. During CGM period, patients injected insulin themselves from day 1 to day 2, and patient’s insulin IT was given by two independent specialist nurses, with insulin injected by nurses from day 3 to day 4. The primary endpoint was the correlation between the insulin IT and the mean amplitude of glycemic excursion (MAGE). Results: A total of 60 diabetic inpatients were recruited and completed the study. The mean score of patients’ insulin IT of patients was lower than that of nurses (p<0.05). We observed that the MAGE value was significant different between the two injections period (P<0.05), and needle reuse and rotation of injection site were negatively correlated to MAGE and HbA1c values, respectively. Conclusion: Insulin IT was negatively correlation to short- or long-run glycemic control in T2D patients with long-acting insulin analogue therapy.

Economic impact of multiple insulin injection therapy for type 2 diabetic patients

2000 ◽  
Vol 50 ◽  
pp. 126-127
Author(s):  
Hideki Kishikawa ◽  
Nakayasu Wake ◽  
Yasuo Ohkubo ◽  
Takayuki Sasahara ◽  
Eiichi Araki ◽  
...  
Keyword(s):  
Economic Impact ◽  
Insulin Injection ◽  
Injection Therapy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

scholarly journals Insulin-induced lipohypertrophy: clinical and ultrasound characteristics

2018 ◽  
Vol 21 (4) ◽  
pp. 255-263
Author(s):  
Vadim V. Klimontov ◽  
Mikhail M. Lazarev ◽  
Alexey A. Makhotin ◽  
Andrey Ju. Letyagin ◽  
Lilia A. Anisimova ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Insulin Dose ◽  
Diagnostic Technique ◽  
Insulin Injection ◽  
Postprandial Glucose ◽  
Insulin Antibodies ◽  
Injection Technique

Background: Lipohypertrophy is primary dermal complication of insulin therapy. The data on the prevalence of lipohypertrophy in diabetic subjects are inconsistent, that may be due to the lack of sensitivity and subjectivity of palpation as diagnostic technique. Meanwhile, the reliability of lipohypertrophy detection can be increased by ultrasound. Aims: to compare clinical and ultrasound characteristics and to determine the risk factors of insulin-induced lipohypertrophy in diabetic subjects. Materials and methods: We observed 82 patients, including 26 individuals with type 1 diabetes and 56 subjects with type 2 diabetes. Duration of insulin therapy varied from 3 months to 37 years (median 14 years). The sites of insulin injections were assessed by palpation and ultrasound. Visualization protocol included gray-scale densitometry, strain elastography, and 3D Doppler power ultrasound. Scaled evaluation of ultrasound sings was applied. Insulin injection technique was assessed by questionnaire. Serum levels of insulin antibodies were determined by ELISA. Results: Lipohypertrophy was revealed by palpation and ultrasound in 57 and 80 patients (70% and 98%) respectively. Total lipohypertrophy area, acoustic density and total ultrasound score showed weak positive correlations with daily insulin dose (r=0.3, r=0.3 and r=0.35, respectively, all p0.006). Patients receiving insulin analogues had smaller area of abdominal lipohypertrophy than those on human insulin (p=0.03). A positive correlation was found between abdominal lipohypertrophy area and mean postprandial glucose (r=0.35, p=0.001). A rare needle change and injections in lipohypertrophy sites were the most common deviations in insulin injection technique (70 and 47 subjects, 85% and 53% respectively). The levels of insulin antibodies showed no association with lipohypertrophy parameters. Conclusions: Patients with type 1 and type 2 diabetes demonstrate high prevalence of lipohypertrophy in insulin injection sites. Ultrasonography is more sensitive method of diagnostics of lipohypertrophy compared with palpation. Insulin-induced lipohypertrophy is associated with errors in injection technique and higher insulin doses.

scholarly journals Guidelines adherence in the prevention and management of chronic kidney disease in patients with diabetes mellitus on the background of recent European recommendations – a registry-based analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Peter Bramlage ◽  
Stefanie Lanzinger ◽  
Sascha R. Tittel ◽  
Eva Hess ◽  
Simon Fahrner ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Analysis Data ◽  
Disease Diagnosis ◽  
Diabetic Patients ◽  
European Society Of Cardiology

Abstract Background Recent European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) guidelines provide recommendations for detecting and treating chronic kidney disease (CKD) in diabetic patients. We compared clinical practice with guidelines to determine areas for improvement. Methods German database analysis of 675,628 patients with type 1 or type 2 diabetes, with 134,395 included in this analysis. Data were compared with ESC/EASD recommendations. Results This analysis included 17,649 and 116,747 patients with type 1 and type 2 diabetes, respectively. The analysis showed that 44.1 and 49.1 % patients with type 1 and type 2 diabetes, respectively, were annually screened for CKD. Despite anti-diabetic treatment, only 27.2 % patients with type 1 and 43.5 % patients with type 2 achieved a target HbA1c of < 7.0 %. Use of sodium-glucose transport protein 2 inhibitors (1.5 % type 1/8.7 % type 2 diabetes) and glucagon-like peptide-1 receptor agonists (0.6 % type 1/5.2 % type 2 diabetes) was limited. Hypertension was controlled according to guidelines in 41.1 and 67.7 % patients aged 18–65 years with type 1 and 2 diabetes, respectively, (62.4 vs. 68.4 % in patients > 65 years). Renin angiotensin aldosterone inhibitors were used in 24.0 and 40.9 % patients with type 1 diabetes (micro- vs. macroalbuminuria) and 39.9 and 47.7 %, respectively, in type 2 diabetes. Conclusions Data indicate there is room for improvement in caring for diabetic patients with respect to renal disease diagnosis and treatment. While specific and potentially clinically justified reasons for non-compliance exist, the data may serve well for a critical appraisal of clinical practice decisions.

scholarly journals An Analysis of Patient Acceptance and Safety of a Prefilled Insulin Injection Device

2009 ◽  
Vol 3 (6) ◽  
pp. 1439-1441 ◽  
Author(s):  
Lisa Kroon
Keyword(s):  
Insulin Injection ◽  
Ease Of Use ◽  
Patient Acceptance ◽  
Delivery Device ◽  
Injection Device ◽  
Randomized Controlled ◽  
Clinical Advantage ◽  
Injection Force

This article summarizes and interprets the findings of Carter and colleagues in this issue of Journal of Diabetes Science and Technology, a study of the real world use of a prefilled insulin pen device. In this observational study, people with type 1 and type 2 diabetes rated their experience with the SoloSTAR pen device after 6–10 weeks of use. Data on patient satisfaction, product technical complaints, and adverse effects were reported. Randomized, controlled trials are needed that compare the various pen devices and the vial/syringe in terms of accuracy of dosing, adherence to therapy, and ease of use (including patient perception of injection force required) to assess whether a particular method of insulin delivery or pen delivery device provides a clinical advantage over another.

scholarly journals Prevalence and risk of appearence of skin lesions considered to be cutaneous markers of diabetes in a population group in bihor county

2012 ◽  
Vol 19 (3) ◽  
pp. 285-290
Author(s):  
Denisa Kovacs ◽  
Luiza Demian ◽  
Aurel Babeş
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Skin Lesion ◽  
Skin Diseases ◽  
Population Group ◽  
Skin Lesions ◽  
Diabetic Patients ◽  
Cutaneous Lesions

Abstract Objectives: The aim of the study was to calculate the prevalence rates and risk ofappearance of cutaneous lesions in diabetic patients with both type-1 and type-2diabetes. Material and Method: 384 patients were analysed, of which 47 had type-1diabetes (T1DM), 140 had type-2 diabetes (T2DM) and 197 were non-diabeticcontrols. Results: The prevalence of the skin lesions considered markers of diabeteswas 57.75% in diabetics, in comparison to 8.12% in non-diabetics (p<0.01). The riskof skin lesion appearance is over 7 times higher in diabetic patients than in nondiabetics.In type-1 diabetes the prevalence of skin lesions was significantly higherthan in type-2 diabetes, and the risk of skin lesion appearance is almost 1.5 timeshigher in type-1 diabetes than type-2 diabetes compared to non-diabetic controls.Conclusions: The diabetic patients are more susceptible than non-diabetics todevelop specific skin diseases. Patients with type-1 diabetes are more affected.

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