The Significance of Repeated Education in Correcting Insulin Injection Techniques and Improving Glycemic Control

Abstract

Background: The success of insulin therapy in achieving glycemic control highly relies on proper insulin injection practices. Proper insulin injection technique is crucial for optimizing the efficacy of insulin therapy. Therefore, it becomes imperative to train people with diabetes on standard insulin injection techniques. In some clinic settings, the education about the technique of injection may be delivered only once, and there is possibility that the patients can still commit mistakes while administering insulin. Ensuring proper insulin injection practices can help improve hemoglobin A1c (HbA1c) and achieve good glycemic control. Aim and Objective: This study aimed to assess the significance of wrong insulin injection techniques on poor glycemic control, and the impact of brief education sessions in inculcating proper insulin injection practices among patients with Type 2 diabetes mellitus (T2DM) was assessed in a real-world diabetes care setting. Methods: A retrospective analysis was conducted for the past 2 years among T2DM patients who exhibited improper injection techniques despite attending a 15-min training session. They were asked to fill in a questionnaire as well as their injection sites were examined. They were again made to attend the session and followed up for the succeeding 6 months to understand the underlying benefits of such training episodes. Results: Among people with T2DM, 126 individuals were identified with wrong injection practices. The mean HbA1c was 10.42% ± 2.33%, mean fasting blood glucose 199.60 ± 82.46 mg/dL, and mean postprandial blood glucose 236.70 ± 96.11 mg/dL. The participants' average number of insulin shots a day was 2.85 ± 1.11. The site of injection was incorrect in 20.17% of the patients; in 35.65%, the procedure of injecting was incorrect; and 11.97% did not follow injection site rotation. 18.80% of the patients presented with lipodystrophy or lipoatrophy. Conclusion: Improvement of insulin injection technique requires the involvement of all the key stakeholders in insulin therapy, these being diabetes educators and/or nurses, physicians, patients, and needle/device manufacturers. However, there is a need for clear guidance for diabetes educators and other health-care professionals so that they can, in turn, educate their patients to successfully self-manage their insulin therapy.