Improved insulin injection technique, treatment satisfaction and glycemic control: Results from a large cohort education study

Malgorzata Gorska-Ciebiada,Malgorzata Masierek,Maciej Ciebiada

doi:10.1016/j.jcte.2020.100217

Malgorzata Gorska-Ciebiada, Malgorzata Masierek + Show 1 more

Open Access

https://doi.org/10.1016/j.jcte.2020.100217

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Abstract

ObjectiveThe aim of this study was to elucidate injection techniques, treatment satisfaction and glycemic control after education among patients with type 2 diabetes. Methods4513 insulin-treated diabetic patients enrolled in the observational study EGIDA II (Education and GensuPen In Diabetology II) filled out the questionnaire which focused on key insulin injection parameters, pain sensation scale and satisfaction of the treatment form before (visit 1) and after 3 months treatment with insulin injection (visit 2). The education was performed by trained healthcare professionals. To assess the utility and comfort during using new automatic injection system (GensuPen) we separated 2 groups: A – treated with GensuPen and B – treated with other pens. ResultsThe education resulted in increased number of patients who properly remix cloudy insulin; inject insulin into skin; change every time the injection site; use the pen needle only once; prepare a pen for injection and store insulin. We noticed significant decrease in BMI and sensation of pain in both groups. Our study revealed that patients’ satisfaction with the treatment increased with each of the 5 items (type of the treatment, mood, physical activity, vital energy, a sense of control over the disease) using a 5-point scale, with greater increase in group A. The utility and comfort (weight, thickness, easiness in remove pen cap, cleaning, twisting, keeping in hand the pen, dial the dose, readable signaling of injected dose) during using the GensuPen significantly increased in group A. Finally the mean glucose level in self-control diary was significantly lower after 3 months of the treatment in both groups, however the difference between visit 1 and 2 was greater in group A. ConclusionThe study showed that proper selection of pen and professional education can result in the improvement of insulin injection technique, higher patients’ satisfaction and better glycemic control.

Highlights

Type 2 diabetes (T2DM) represents a global health problem with the heavy socio-economic burden
According to the study design 4513 patients were dived into 2 groups: group A – treated with GensuPen included 3765 subjects and group B – treated with other pens included 748 subjects
This study performed in large cohort of type 2 diabetic patients was the first in Poland, which described injection techniques, treatment satisfaction and glycemic control before and after education

Summary

Introduction

Type 2 diabetes (T2DM) represents a global health problem with the heavy socio-economic burden. This chronic disease is predicted to affect approximately 415 million adults by 2015 and almost 642 million adults by 2040 [1]. It caused around 5 million deaths in 2015 and up to 1,197 billion dollars were spent due to diabetes worldwide [1]. T2DM is associated with severe complications (e.g. cardiovascular disease, kidney failure, blindness, lower limb amputations) which can cause a death or shorten patients’ life with lowering quality of life [2,3]. Polish Diabetes Association as well as European and US guidelines recommend insulin as an option after life style modification and metformin to bring glycated haemoglobin (HbA1c) below a general target of 7% (53 mmol/mol) [4,5,6]

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