Insulin Injection Techniques

AbstractBackgroundInsulin therapy is a major part of diabetes treatment. The insulin injection technique must be done accurately and needs a professional process for diabetes mellitus (DM) patients. The aim of this research is to evaluate the relationship of education level pertaining to the accuracy of insulin injection techniques through HbA1c values.MethodsWe used a cross-sectional study with sampling using a purposive technique according to the inclusion criteria: diagnosed with DM and using insulin therapy with/without a combination of oral antidiabetic drugs, having HbA1c levels of data ± 3 months from the time of study, willing to become research respondents by signing informed consent. The study was conducted by filling out the questionnaire Forum for Injection Technique and Therapy Expert Recommendation (FITTER) and interviews.ResultsFifty subjects with primary education were able to perform insulin injection techniques with 20% accuracy while subjects with secondary education level showed 14% accuracy, and higher education 2%. All of these results had HbA1c values > 6.5%. 100 % of the subjects were provided with educational resources and 78% had a care-giver at home. Statistical analysis of correlation between levels of education with the accuracy of the insulin injection technique was carried out through the Somers’ correlation test (p = 0.81, r = −0.03). This study shows there is no relationship between the level of education and the accuracy of insulin injection techniques through HbA1c values. This might occur due to several factors such as information sources and caregiver’s practice.

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A New Medical Device for Improved Rotation of Insulin Injections in Type 1 Diabetes Mellitus: A Proof-of-Concept Study

Journal of Diabetes Science and Technology ◽

10.1177/1932296820950688 ◽

2020 ◽

pp. 193229682095068

Author(s):

Carina Kirstine Klarskov ◽

Yasmin Hassan Hamid ◽

Rasmus Tjalk-Bøggild ◽

Lise Tarnow ◽

Peter Lommer Kristensen

Keyword(s):

Type 1 Diabetes ◽

Medical Device ◽

Insulin Injection ◽

Glucose Variability ◽

Proof Of Concept ◽

Concept Study ◽

Interstitial Glucose ◽

Injection Techniques ◽

Secondary Endpoints

Introduction: Lipohypertrophy (LH) is caused by repetitively injecting insulin into the same location. This can lead to unpredictable insulin absorption and increased glucose variability (GV). A new medical device, ROTO Track, automatically guides the user to rotate abdominal insulin injections to avoid LH lesions. This study aimed to test whether the medical device could reduce the number of insulin injections in the same subcutaneous area as compared with non-aided standard insulin injection techniques. Methods: In this proof-of-concept cross-over study, baseline data about injection site in the abdominal region were collected blinded for 1 week with a nonguiding version of the device and compared to 1 and 12 weeks of device guidance in 35 people with type 1 diabetes. The device registered time and location of abdominal injections. The primary endpoint was a “rotation score.” Secondary endpoints included number and size of LH, GV, and hemoglobin A1c. Results: The rotation score improved significantly from a baseline mean of 40.2% to 49.9% after 1 week (confidence interval: 2.2-17.2%, P = .012) and improved further after 12 weeks to 52.2% ( P < .001). After 12 weeks, LH was reduced both in median size from 9.2 (range: [0.9-29.4]) cm2 to 5.4 (range: [0.0- 26.8]) cm2 ( P = .041) and mean count from 1.4 (range: [1-2]) to 1.1 (range: [0-2], P = .039) and the coefficient of variation of interstitial glucose was reduced from 38.6 to 35.1 ( P = .009). Conclusion: This proof-of-concept study indicates that the device improves rotation of insulin injections, and reduces LH and GV.

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Practice of insulin injection techniques among persons with diabetes in central India: an observational survey

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20211434 ◽

2021 ◽

Author(s):

Animesh Choudhary ◽

Jitendra Chouhan ◽

Sanjeev Gulati ◽

Jogesh Kumar Vishandasani

Keyword(s):

Injection Site ◽

Tertiary Care ◽

Central India ◽

Insulin Injection ◽

Cross Sectional Study ◽

Injection Technique ◽

Insulin Administration ◽

Cross Sectional ◽

Injection Techniques ◽

Tertiary Care Centers

Background: Correct injection technique used by the patient can determine the outcomes with insulin therapy in type 2 diabetes mellitus, however most patients on insulin remain unaware of the proper insulin injection techniques. The purpose of this study was to assess the current practice of insulin administration among diabetes patients.Methods: This cross-sectional study was conducted in 3 tertiary care centers delivering specialized diabetes care in central India from November 2019 to February 2020. The study included patients (n=150) using insulin for at least three months by either syringe or pen. All of them answered a survey questionnaire which focused on key insulin injection parameters.Results: Abdomen was the most common (53.33%) site of insulin injection. About 95.33% of subjects were following the injection site rotation instructions. The practice of hand washing, and cleaning of the injection site was practiced by 120 (80%) and 112 (74.66%) respondents respectively. Needle reuse was a common practice, and 146 (97.33%) subjects were using the same needle more than once. Around 73.33% were storing insulin at proper temperature, while 54.66 % reported having pain at the injection site and 14.66% had noticed persistent swelling at their injection sites. Conclusions: There is a signiﬁcant gap between the insulin administration guidelines and current insulin injection practice. Education and counseling about proper insulin injection techniques should be provided to all persons with diabetes to ensure optimal usage of the drug to achieve the desired glycemic control.

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A study to assess the effectiveness of a structured teaching programme on knowledge and practice of safe insulin administration among nurses in a tertiary care hospital: A pre-post design

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n3p72 ◽

2019 ◽

Vol 10 (3) ◽

pp. 72

Author(s):

Pankaj Punjot ◽

Valsa Thomas ◽

Sudhaya Vinodkumar ◽

Maninder Singh Setia

Keyword(s):

Demographic Data ◽

Tertiary Care ◽

Insulin Injection ◽

Training Programme ◽

Average Score ◽

Care Hospital ◽

Insulin Administration ◽

Teaching Programme ◽

Injection Techniques ◽

Injection Practices

Background and objective: Diabetes Mellitus (DM) is not only a health issue but also an economic issue in India. Incorrect insulin injection techniques can lead to side effects such as pain, lipohypertrophy, and poor glycemic control. We designed the present study to assess nurses’ knowledge about safe insulin administration and evaluate the role of a planned teaching programme on knowledge and practices of safe insulin injection techniques in a group of nurses in tertiary care hospital.Methods: This is a pre-post design to study the effectiveness of the structured training programme - one hour of didactic lecture followed by demonstration of safe injection practices. Demographic data and knowledge about safe insulin practices were collected at baseline. We conducted two post training assessments–day one and three months after training. The injection practices were assessed using a check-list. We used the random effects linear regression model to identify factors associated with change in scores over these three observations.Results: The mean (SD) scores for insulin knowledge at baseline was 6.81 (2.28). It significantly increased to 16.85 (1.84) immediately after training (p < .001). These scores reduced significantly after three months compared with post-training scores (14.18 [2.14]; p < .001). A significantly higher proportion of nurses had used re-suspension technique for insulin injection after three months (76.3% vs 52.5%, p = .003) and cleaned the injection site with alcohol swab before injection (93.8% vs. 75.0%, p = .001). On an average, knowledge scores changed by -0.15 (95% CI: -0.29, -0.02; p = .03) with each unit increase in age (years). The average score in nurses with a degree was significantly higher compared with those who had a diploma (1.02, 95% CI: 0.28, 1.76; p = .007).Conclusions: The study demonstrated that insulin injection practices improve with adequate guidance and information. However, there is a need to have a regular training programme to sustain the practices. Certain practices such as site rotation and assessing lipo-hypertrophy, and the relation between these two should be emphasized in these sessions.

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