Lipohypertrophy monitoring study (LIMO): effect of injection site rotation and education on glycemic control

Objective: To determine the trends in insulin injection technique and associatedcomplications in the local diabetic patients. Study Design: Cross-Sectional Descriptive study.Place and Duration of Study: This study was conducted in Department of Medicine at FatimaMemorial College & Hospital Lahore from 25th May 2015 to 25th October 2015. Patientsand Method: Three hundred patients above 18 years of age who presented in outdoor andindoor department of the hospital, gave consent were enrolled. The data was collected throughinterview and relevant physical examination; data was analyzed by using SPSS 20.0 version.Results: 300 diabetics were enrolled; 108 (36%) male and 192 (64%) female. Mean age inmales was 52.8±13.7 and in females was 52.2±11.8. Duration of insulin use was less than5 years in 175 (58%) and 5 years or more in 125 (42%). Insulin syringe of 8 mm gauge wasbeing used by 263 (87%). Abdomen was the injection site in 202 (67%); however, 279 (93%)rotated the injection site. The angle of injection was kept at 90 degrees by 254 (85%). Theneedle was reused for five or more times by 187 (52%) and 216 (72%) were self-injecting. Localcomplications were seen in 105 (35%); out of those pain was most commonly (35 %) reported.Among age groups significant association (p<0.05) was seen in site of insulin delivery, in agemore than 60 years more injected in abdomen. In gender groups more males (83%) wereself-injecting. Significant association (p<0.05) was seen in duration of insulin use and localcomplications. Majority, 126(72%) of those who were on insulin for less than 5 years did nothave complications. Conclusion: Majority of our patients had adopted reasonable techniquehowever repeated reinforcement can further improve appropriate insulin delivery, less wastageof insulin and better glycemic control with less chance of complications.

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Assessment of knowledge, attitude and practice of insulin injection among subjects with diabetes mellitus

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20213369 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1130

Author(s):

Bezawada Shravani ◽

Anuradha H. V. ◽

Pramila Kalra

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Injection Site ◽

Common Adverse Effect ◽

Insulin Injection ◽

Diabetic Patients ◽

Time Duration ◽

Attitude And Practice ◽

Validated Questionnaire ◽

Knowledge Attitude And Practice

Background: Diabetes mellitus (DM) is a spectrum of common metabolic disorders whose management mainly lies in treating the patients with oral hypoglycemic drugs and insulin along with the dietary and lifestyle modifications. Insulin is administered most subcutaneously. As the insulin injection sites are relatively painless, patients tend to inject in the same area repeatedly rather than moving to a newer site and increase risk for development of injection site reactions like lipodystrophy and impairment of glycemic control. Hence, it is utmost important for every diabetic patient and their relatives who would inject the insulin injection to be aware of appropriate manner of insulin injection. This helps in maintaining adequate glycemic control in diabetic patients. The main objective of this study was to assess the knowledge, attitude and practice of insulin injection technique among the diabetic patients.Methods: A cross-sectional study was conducted in the department of Endocrinology on 250 diabetic patients taking insulin injections based on inclusion and exclusion criteria. A validated questionnaire was administered to patients to answer in order to assess their knowledge, attitude and practice about technique of insulin injection.Results: In this study, it was found that 90% of the patients were aware of rotating the injection site, whereas only 40% of the patients were aware of appropriate time duration (5-10 sec for syringes/counting 1-15 for releasing the pen) required for resting the syringe/pen needle inside the skin. Only 48% of the patients used to remove the air bubble prior to injection, 57% pinched the injection site before injecting, 20% rubbed the injection site after injection and 30% used to wash hands prior to injection. Hypoglycemia was the most common adverse effect noted in 54% of patients.Conclusions: It can be concluded from the present study that every patient and his/her attendant needs to be educated and trained appropriately regarding technique of injecting insulin injection for betterment of their health.

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