Effect of Insulin Injection Techniques on Glycemic Control Among Patients with Diabetes

Abstract

Mousa Abujbara,1 Eiman A Khreisat,2 Yousef Khader,3 Kamel M Ajlouni4 1Department of Diabetes and Endocrinology, the National Centre (Institute) for Diabetes, Endocrinology and Genetics/The University of Jordan, Amman, Jordan; 2Department of Nursing, the National Centre (Institute) for Diabetes, Endocrinology and Genetics/The University of Jordan, Amman, Jordan; 3Department of Community Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan; 4Department of Endocrinology and Diabetes, the National Centre (Institute) for Diabetes, Endocrinology and Genetics/The University of Jordan, Amman, JordanCorrespondence: Kamel M Ajlouni, Department of Endocrinology and Diabetes, the National Centre (Institute) for Diabetes, Endocrinology and Genetics/The University of Jordan, Amman, Jordan, Email [email protected]: Previous studies have shown that healthcare professionals rarely instruct patients about proper insulin injection techniques. This study aimed to assess the practices of insulin injection techniques among patients with diabetes treated and assess the effect of these practices on glycemic control.Patients and Methods: This cross-sectional study was conducted between November 2020 and February 2021. A random systematic sampling technique was used to recruit study subjects at specialist outpatient clinics. Subjects with type 1 or 2 diabetes mellitus who had been using insulin injections for at least a year were included in this study.Results: A total of 298 subjects with type 1 diabetes and 553 with type 2 diabetes participated in this study. The mean age of patients with type 1 diabetes was 20.1 ± 10.4 years. The mean age of patients with type 2 diabetes was 58.6 ± 9.5 years. The median type 1 diabetes duration was 6.0 years, and median type 2 diabetes duration was 15.0 years. About 66.8% of patients with type 1 diabetes and 69.4% of patients with type 2 diabetes were rotating insulin injection sites. Almost 36.6% of patients with type 1 diabetes and 50.5% of patients with type 2 diabetes reported using the same insulin needle more than three times. The prevalence of lipohypertrophy was 57.0% among patients with type 1 diabetes and 55.5% among patients with type 2 diabetes. The absence of lipohypertrophy, rotation of insulin injection site, and total daily insulin dose ≤ 50 units were all independently significantly associated with better glycemic control.Conclusion: Insulin injection techniques were suboptimal among significant proportion of patients with diabetes in Jordan. Improper insulin injection technique, especially the rotation of injection sites and lipohypertrophy formation, was associated with uncontrolled blood glucose levels. Educational interventions that focus on insulin injection techniques among Jordanian patients with diabetes are strongly recommended.Keywords: type 2 diabetes mellitus, type 1 diabetes mellitus, insulin therapy, lipohypertrophy

Keywords

• type 2 diabetes mellitus
• type 1 diabetes mellitus
• insulin therapy
• lipohypertrophy.