| Abstrakt: |
Aim. A large pan-European epidemiologic survey of insulin injection techniques was performed in order to determine the epidemiologic profile by centre, country and continent of major issues surrounding insulin injection. Methods. European insulin-injecting, type 1 or 2 diabetes patients, using insulin for at least 6 months via an insulin pen or syringe; 22 sites in seven countries, 1002 patients in total, 51% female, 58% type 1. Results. Nearly 70% of patients inject using a pinch-up and this practice is associated with improved HbA1c. Thirty per cent of patients reported having lipohypertrophy. Concurrent nurse evaluation found the prevalence to be 27%. Independent risk factors for lipohypertrophy were found to be failure by the patients to check injection sites regularly, failure to rotate sites and longer duration of DM. Less than 50% of patients reported that they were taught about lipohypertrophy. Needles were used 3.3 times on average in Europe, with wide variation by country. Male sex, type 1 diabetics, a high daily number of injections and the use of the 12.7 mm length needle were factors associated with high needle reuse. Needle reuse, even more than once, increased the risk of lipohypertrophy by 31%. Nearly half of patients dispose of their needles directly into the trash after protecting the needle (recapping or clipping). Alarmingly, 22% dispose directly into the trash without protection. Conclusion. There is a considerable way to go in ensuring optimal insulin injection practices. The issues raised by this study must be addressed by focused and intensive HCP efforts. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR] |
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