Difficulties presented by patients with diabetes in self-administration of insulin: scoping review

Abstract

Introduction: Diabetes is a disease with a high incidence in the world population. One of the treatment alternatives for this disease is the use of subcutaneous insulin therapy, daily, most often applied by the patients themselves. As a result, patients that are not properly trained in insulin self-administration may develop complications from its use. Objectives: Describe the evidence in order to explain the difficulties of patients with diabetes in the process of self-administration of insulin. Methods: A literature review was carried out using the scoping review method, in LILACS, CINAHL, PubMed, Cochrane Library, SCOPUS, SciELO, Biblioteca Digital de Teses e Dissertações USP, Busca Integrada USP, and CAPES Thesis Bank. We included articles that had insulin users as participants; that explored the difficulty presented by patients; and that studied the process of insulin self-application. Results: Twenty-six studies published between 1998 and 2020 were selected. The analysis pointed to 12 categories about the difficulties encountered in the self-application process, of which the most relevant were: pain, fear, difficulty in knowing the correct dose and/or adjusting it based on capillary glycemia, lack of knowledge about the application technique, and functional alteration. Conclusion: Pain was the most common objection found in the studies, which reflects its relationship with other difficulties. The difficulty in knowing the dose and/or adjusting it according to capillary blood glucose was presented in a considerable amount, in order to infer the deficiency of health education conducts in Primary Health Care.

Keywords

• self-care
• diabetes mellitus
• subcutaneous injections
• procedural pain
• health knowledge
• attitudes
• practice
• medication errors