Diabetes, Metabolic Syndrome and Obesity (Dec 2023)
Expert Opinion on Addressing the Gap in Injection Technique and Needle Reuse for People with Diabetes in Indonesia
Abstract
Pradana Soewondo,1 Ketut Suastika,2 Ida Ayu Kshanti,3 Mardianto Mardianto,4 Sony Wibisono Mudjanarko,5 R Bowo Pramono,6 Dyah Erti Mustikawati7 1Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 2Department of Internal Medicine, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G Ngoerah General Hospital Denpasar, Bali, Indonesia; 3Department of Internal Medicine, Fatmawati General Hospital, Jakarta, Indonesia; 4Faculty of Medicine, University of Sumatra Utara/Adam Malik Central Hospital, Internal Medicine, Medan, Indonesia; 5Department of Internal Medicine, Faculty of Medicine Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; 6Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia; 7Ministry of Health Republic of Indonesia, Jakarta, IndonesiaCorrespondence: Pradana Soewondo, Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia, Tel +6221 390 7703, Email [email protected]: The use of insulin for patients with diabetes mellitus in Indonesia appears to be under expectation; moreover, there are gaps in knowledge regarding the proper injection technique and pen needle reuse by both healthcare professionals (HCPs) and patients. To address these issues, a scientific expert meeting was held with the participation of endocrinologists and public health specialist from many different organizations in Indonesia to identify the challenges and problem related to injection technique, high pen needle reuse rate, and the need of all stakeholders. The experts agreed that it is necessary to ensure physicians to start the initiation phase as early as indicated, continue optimizing its dosage to reach targeted blood sugar based on guideline, and involve all relevant stakeholders to improve insulin distribution and patient access in every primary care facility in order to optimize the use of insulin or other injectable diabetes medications in Indonesia. Additionally, the experts believed that education on proper injection technique and improved reuse rate of pen needle is necessary. To date, Indonesian Diabetes Educators Association (IDEA/PEDI) has established guideline on injection technique. There are also recommendations on injection technique and needle reuse from Indonesian Society of Endocrinology (PERKENI) and Forum for Injection Technique & Therapy: Expert Recommendations (FITTER); however, this guideline/recommendation should be disseminated more widely among HCPs. In addition, cost-effectiveness studies based on local data are needed to propose and convince the Payors and other stakeholders. This article can be used as a guidance for HCPs and policymakers to improve current practice on injection technique, pen needle reuse, needle prescription and reimbursement policy in Indonesia and elsewhere.Keywords: diabetes mellitus, expert opinion, GLP-1 receptor agonist, injection technique, insulin, needle reuse
