Insulin Injection Practices in a Population of Canadians with Diabetes: An Observational Study

Bari, Basel; Corbeil, Marie-Andrée; Farooqui, Hena Shamim; Menzies, Stuart; Pflug, Brian K.; Smith, Brennan K.; Vasquez, Arthur; Berard, Lori

doi:10.1007/s13300-020-00913-y

Cited by 17 publications

(18 citation statements)

References 41 publications

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“…Consistent with the literature [ 29 , 30 ], this study found that patients skipped all aspects of priming insulin pen before injection, which could affect the effectiveness of needle and the existence of air bubbles. It has also been suggested to keep the needle under the skin in 6 to 10 seconds before withdrawal to ensure full absorption of insulin, but this practice was found only in around one-third of patients in our study, which is lower than Bari et al (39%) and Poudel et al (53.5%) [ 29 , 30 ]. Errors in the insulin injection technique also included not removing the needle cap and used needle from pen after injection (90%) and not mixing cloudy insulin (51.2%).…”

Section: Discussionsupporting

confidence: 88%

The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam

Chu

Nguyen

Pham

et al. 2021

Journal of Diabetes Research

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Background. Patients with type 2 diabetes mellitus (T2DM) who have limited knowledge about hypoglycemia and insulin pen use are likely to have hypoglycemia and other complications. Objective. This study aimed to evaluate the effectiveness of health education on knowledge about hypoglycemia and insulin pen use among outpatients with T2DM at a primary care hospital in Vietnam. Methods. A pretest–posttest study was conducted among 80 patients with T2DM at District 11 Hospital in Ho Chi Minh City, Vietnam. At baseline, patients were interviewed through a predefined, structural questionnaire to assess their knowledge about hypoglycemia and insulin pen use. After that, patients underwent an individual health education session about hypoglycemia and insulin pen. One month and two months after this intervention, knowledge about hypoglycemia and insulin pen use were recorded again. Results. The majority were males (65.0%) and the mean age was 59.6 (standard deviation 8.1, range 35-75) years. Very few patients had good knowledge and proper insulin pen use, with percentages ranging from 13.8% to 60%. There was a significant improvement of knowledge and practice after the intervention. Such improvement remained high one month and two months after the intervention. Conclusions. The health education intervention is effective in improving knowledge and practice in this population. There is a pressing need for such intervention at primary care hospitals to optimize treatment for patients with T2DM, possibly focusing on those who had characteristics to have the best effectiveness found in this study.

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Section: Discussionsupporting

confidence: 88%

The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam

Chu

Nguyen

Pham

et al. 2021

Journal of Diabetes Research

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“…Several studies had described that patient preference and satisfaction on the use of insulin pen devices lead to increased patient compliance. [32][33][34] Educators should inform subsequently standardized guidance around insulin including injection sites and method. Incorrect knowledge about insulin injections, for example, needle reuse, of patients with diabetes may lead to lipohypertrophy in the injection area, which increase hypoglycemia risk.…”

mentioning

confidence: 99%

“…Incorrect knowledge about insulin injections, for example, needle reuse, of patients with diabetes may lead to lipohypertrophy in the injection area, which increase hypoglycemia risk. [34][35][36][37][38][39] The majority of AEs in the present study were mild. There were four events of SAEs in the EZL group and seven SAEs in the LAN group.…”

mentioning

confidence: 99%

Immunogenicity and Efficacy of Insulin Glargine Biosimilar Ezelin versus Originator Insulin Glargine in Patients with Type 2 Diabetes

Tarigan¹,

Dwijayanti²,

Setyowati³

et al. 2021

DMSO

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“…51 Many participants reported using a smaller than recommended area for their insulin injections (64%), reusing their PNs (39%), or injecting into lipohypertrophic tissue (lumps or bumps under their skin; 37%). 51 Lipohypertrophy (LH) is a common complication of insulin injections in people with diabetes (both type 1 and type 2), with reported prevalence ranging from 30 to 65% depending on study population. 30,52,53 Predisposing factors for LH development that have been described include small skin area size in which injections are applied repeatedly, failure to rotate injection sites, needle reuse, low BMI (underweight), and use of ice-cold insulin.…”

Section: Injection Technique Educationmentioning

confidence: 99%

Needle Technology for Insulin Administration: A Century of Innovation

Heinemann¹,

Nguyen²,

Bailey

et al. 2021

J Diabetes Sci Technol

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Innovations in syringe and pen needle (PN) technology over the last 100 years have led to important advances in insulin delivery for people with diabetes, paralleling the strides made in developing recombinant DNA human insulin and insulin analogs with varying onset and duration of action. In this review, the history of advances in insulin delivery is described, focusing on progress in syringe, needle, and PN technologies. The early glass and metal syringes that required sterilization by boiling have been replaced by disposable, single-use syringes or pens with clear labeling for precise insulin dosing. The early needles ranging in length from 19 to 26 mm that required manual sharpening against a whetstone have been replaced by syringe needles of 6 mm and PNs of 4 mm in length as slender as 34 gauge. Imaging studies using ultrasound and computed tomography measured the thickness of skin and subcutaneous tissue layers to show feasibility of targeted insulin administration with shorter needles. These developments, coupled with innovations in needle/PN wall and tip structure, have led to improved injection experience for people with diabetes. It is also important to acknowledge the role of injection technique education, together with these advances in injection technology, for improving clinical outcomes and patient satisfaction. With continued projected growth of diabetes prevalence, particularly in developing countries where expensive and complex insulin delivery systems may not be practical, insulin syringes and pens will continue to serve as reliable and cost-effective means of insulin delivery for people with diabetes.

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Insulin Injection Practices in a Population of Canadians with Diabetes: An Observational Study

Cited by 17 publications

References 41 publications

The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam

The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam

Immunogenicity and Efficacy of Insulin Glargine Biosimilar Ezelin versus Originator Insulin Glargine in Patients with Type 2 Diabetes

Needle Technology for Insulin Administration: A Century of Innovation

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