Transportation, storage and injection practices of insulin among patients with diabetes mellitus attending a medical clinic at a tertiary care centre in Sri Lanka

Abstract

Background: Failure to maintain the cold chain during the transportation and storage of insulin and incorrect techniques of insulin injection lead to fluctuations of glycaemic control and complications among patients with diabetes mellitus. Objective: The study assessed transportation, storage, and injection practices of insulin among diabetic patients. Methods: A descriptive cross-sectional study was conducted among 200 consecutive diabetic patients on regular insulin attending a follow-up medical clinic at National Hospital, Colombo. An interviewer-administered questionnaire was used to collect data on patients’ socio-demographic factors, insulin transportation methods, storage, and injection practices. Results: All the study participants (age 59 SD±11.5; males 44.5%; females 55.5%) were on premixed insulin while 15% (n=30) used additional soluble insulin. The majority (56%) failed to maintain the cold chain during transportation while 1.5% (n=3) stored insulin in the freezer compartment. Only 33.5% (n=67) had glucometers at home to monitor their glucose levels and 27% failed to comply with the recommended dosage. Only 52.5% (n=105) adhered to the correct timing recommended. The majority (95.5%; n=191) practiced rotation of the injection site and 32% (n=64) rolled the vial between palms before injection. A minority (24.5%) failed to clean the injection site while 63.5% (n=127) practiced pinching of the skin fold before injection. All 6 steps of insulin injection were correctly practiced by 6.5% (n=13) denoting significant lapses in their knowledge and technique. Conclusion: A significant number of insulin users follow incorrect transportation and injection practices. Interventions are required to improve them