INSULIN TREATED PATIENTS

INAPPROPRIATE INJECTION TECHNIQUE CONTRIBUTES TO COMPLICATIONS AND GLYCEMIC VARIABILITY

Abstract

Objective: To determine the trends in insulin injection technique and associated
complications 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 Fatima
Memorial College & Hospital Lahore from 25th May 2015 to 25th October 2015. Patients
and Method: Three hundred patients above 18 years of age who presented in outdoor and
indoor department of the hospital, gave consent were enrolled. The data was collected through
interview 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 in
males was 52.8±13.7 and in females was 52.2±11.8. Duration of insulin use was less than
5 years in 175 (58%) and 5 years or more in 125 (42%). Insulin syringe of 8 mm gauge was
being 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%). The
needle was reused for five or more times by 187 (52%) and 216 (72%) were self-injecting. Local
complications 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 age
more than 60 years more injected in abdomen. In gender groups more males (83%) were
self-injecting. Significant association (p<0.05) was seen in duration of insulin use and local
complications. Majority, 126(72%) of those who were on insulin for less than 5 years did not
have complications. Conclusion: Majority of our patients had adopted reasonable technique
however repeated reinforcement can further improve appropriate insulin delivery, less wastage
of insulin and better glycemic control with less chance of complications.