Improving Insulin Injection Techniques Improves Glycemic Control

Improper insulin technique can greatly affect glycemic control….

Insulin plays a great role in glycemic control in both type 1 and type 2 diabetics. However, the act of injecting oneself with drugs is not a normal activity for many patients and can thus cause anxiety. Furthermore, instruction in self-injection is often only given at the start of insulin treatment and often patients cannot understand how to self-inject insulin perfectly. In this study, researchers aimed to evaluate the effectiveness of re-education in the insulin injection technique for glycemic control.

The study included 87 diabetic patients from a single outpatient clinic in Japan. The patients included had been treated with insulin for more than 3 years, and could administer insulin injections by themselves. Glycemic levels were monitored for any adverse events and insulin levels were adjusted as necessary. The authors did not re-educate on a change in diet or the rate of self-glucose monitoring during this study period. HbA1c and glycoalbumin levels were used as glycemic control indices.

In the results, the mean HbA1c level at the start of re-education was 7.46 ± 0.09%. The level significantly decreased to 7.11 ± 0.09% at 2 months after re-education, to 7.05 ± 0.11% 3 months after re-education, and to 6.73 ± 0.10% 4 months after reeducation. The mean glycoalbumin level before reeducation was 22.76 ± 0.50% and also decreased significantly at 2, 3 and 4 months after re-education. Patients with a poor understanding of self-injection techniques had high levels of HbA1c prior to re-education and a greater rate of decrease in the HbA1c level as a result of re-education. The authors conclude that the re-education in the insulin injection technique led to an improvement in glycemic control in insulin-treated diabetic patients, especially in those with a poor understanding of the insulin injection technique.

Practice Pearls:

• The act of injecting oneself with drugs is not a normal activity for many patients and can thus cause anxiety
• The mean HbA1c level decreased significantly at 2, 3, and 4 months after re-education.
• Patients with a poor understanding of self-injection techniques had high levels of HbA1c prior to re-education and a greater rate of decrease in the HbA1c level as a result of re-education.

Advances in Therapy, September 2013