Rizwana Kitchlew, Inayat Thaver, Shehryar Pervez, Ikram-ul Haq.
Insulin treated patients; inappropriate injection technique contributes to complications and glycemic variability.
Professional Med J Jan ;23(05):576-82.

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.

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