Self-administration Of Insulin Research Articles

BARRIERS TO INITIATE INSULIN THERAPY AND ITS ASSOCIATION WITH DURATION OF DIABETES MELITIS AND DEMOGRAPHIC FACTORS IN UNCONTROLLED TYPE 2 DIABETIC PATIENTS, A CROSS SECTIONAL STUDY

Objectives: To determine different barriers to initiate insulin therapy and association of duration of diabetes mellitus and demographic factors with barriers in initiation of insulin therapy in Uncontrolled type 2 diabetic patients.Materials and Methods: We conducted a cross sectional study conducted among patients with type 2 diabetic patients presenting to endocrinology outpatient clinics in two Tertiary care hospitals of Peshawar ie. Khyber Teaching hospital and hayatabad medical complex Peshawar. The duration of study was 03 months after approval of synopsis. The sample size was 257.The study population was selected by consecutive non probability sampling technique. The data was collected by pre designed questionnaire. All the included patients were interviewed on pre designed questionnaire. Data was processed in SPSS version 22.Results: In study we found that patients face different barriers to initiate insulin therapy. In our study, side effects of insulin was the barrier for 97(37.7%) of the patient, difficulty in carrying insulin was barrier for 128(49.8%) patients , dose adjustment of insulin was barrier for 90(35%) patients, fear if insulin needle was barrier for 89 (34.6%) patients, self administration of insulin was barrier for 98(38.1%) patients , affordability of insulin was barrier accounting for 114(44%) patients , frightened about insulin therapy by someone was barrier for116 (45.1%) patients. The association between economic status of patient and the barrier that they are frightened by someone was statistically significant. Chi-square test was also run between duration of diabetes with all barriers in which one association was found nearly signifi cant i.e. the association of duration of diabetes with difficulty in carrying insulin with the p value of 0.064.Conclusion: The most common barrier in insulin therapy initiation of patients in the study was difficulty in carrying insulin. We found that there is near to signifi cant association between duration of diabetes and difficulty in carrying insulin. There is significant association between economic status of patient and frightened by someone. The lower the economic status the more frightened about Insulin use.

Factors Associated with Insulin Self-Administration Knowledge and Practices Among Hospitalized Diabetes Mellitus Patients in Peshawar, Pakistan

Background: Diabetes Mellitus (DM) is a rapidly growing chronic condition requiring effective management, including insulin self-administration (ISA). Proper ISA knowledge and practices are crucial for optimal glycemic control, yet gaps remain, particularly in low-resource settings.Objective: To assess ISA knowledge and practices among insulin-dependent DM patients and identify associated sociodemographic and clinical factors.Methods: This cross-sectional study was conducted among 116 DM patients at a public hospital in Peshawar, Pakistan. Data were collected through face-to-face interviews and medical records review. Knowledge was assessed using a validated questionnaire based on ADA guidelines, while practices were observed using a structured checklist. Data were analyzed using SPSS version 25, applying descriptive and inferential statistics, including Chi-square tests for associations.Results: Of the participants, 50% had average ISA knowledge, 34.5% had poor knowledge, and 15.5% had good knowledge. Regarding practices, 37.1% exhibited poor, 29.3% fair, and 33.6% good practices. Significant associations were found between ISA knowledge and age (p = 0.004), education (p < 0.001), and previous training (p = 0.002).Conclusion: Knowledge and practices regarding ISA were suboptimal, influenced by age, education, and training. Tailored educational programs are needed to improve DM management.

Assessing Knowledge and Practice of Self-Administration of Insulin among Diabetes Mellitus Patients: Implications for Enhanced Diabetes Care

Assessing Knowledge and Practice of Self-Administration of Insulin among Diabetes Mellitus Patients: Implications for Enhanced Diabetes Care

Assesment and Description of Knowledge Regarding Self-administration of Insulin Injection among Diabetes Mellitus Patient

A descriptive study to assess the knowledge regarding self-administration of insulin injection among diabetes mellitus patient. Objectives 1. To assess the knowledge regarding self-administration of insulin injection among diabetic patient selected OPD. 2. To prepare and distribute on information pamphlet on regarding self-administration insulin injection among diabetic patient selected OPD. 3. To find out the association between the knowledge regarding insulin therapy with the selected demographic variables. Material and Methods The research approach adopted in this study is mixed approach. Quantitative Non-experimental Descriptive Qualitative research design was used. The sample were selected by non-Probability convenient Sampling Technique sample size was 60. Result 1. It shows that according to age majority of subjects 23[38.33%] were in the age group of above 36years. Whereas 20[33.33%] were in age group of 31-35years. Whereas13 [21.67%] where in age group of 26-30 year. Whereas 4[6.67%] were in the age group 20-25years. 2. It shows that maximum 41(68.33%) had average knowledge and 13(21.67%) had a good knowledge and minimum 6(10%) of poor knowledge. 3. It depicts that the area wise analysis of knowledge score by using median, mean percentage, SD and CV. The introduction and definition median was 3, mean 3.15, mean % was 39.38%, S.D. was 1.31, C.V. was 41.59. Introduction of insulin injection & reason of taking injection median was 5, mean 4.68, mean % was 46.8 %, S.D. was 1.23, C.V. was 26.28. Sites of taking injection & method of administrating of injection studies median was 6, mean 5.63, mean % was 70.38%, S.D. 2.23 was C.V. was 39.61, complication median was 3, mean 2.85, mean % was 71.25 %, S.D. was 39.3. 4. Show association between knowledge regarding self-administration of insulin injection among diabetic client attending OPD of selected hospital with selected socio-demographic variables using non-parametric χ2 test. On applying the chi-square test demographic variable “Occupation” and “Duration of self-administration of insulin”, “previous knowledge” was significantly associated with knowledge level. Hence H1 ie, there is significant association between knowledge level with “Occupation” and “Duration of self-administration of insulin”, “previous knowledge” is accepted. Association between knowledge level and other selected sociodemographic variables such as age group (χ2=6.32, p>0.05), gender (χ2=2.47, p>0.05) religious (χ2=4.12, p>0.05) Education (χ2=10.86, p>0.05) family monthly income (χ2=5.15, p>0.05) occupation (χ2=13.40, p>0.05) previous family history of diabetic mellitus (χ2=1.03, p>0.05) duration of diabetic mellitus diagnosed (χ2=5.42 p>0.05) duration of self -administration of insulin(χ2=14.22, p>0.05) previous knowledge regarding insulin injection (χ2= 14.09 p >0.05) if yes, source of information(χ2=7.06, p>0.05). Were found to be statistically not significant. Hence H0 that there is no significant association between selected socio demographic like age, gender, religious, monthly income, education, occupation, duration of diagnosed diabetic mellitus, duration of taking insulin, previous knowledge of insulin injection, source of knowledge with knowledge level regarding self-administration of insulin injection among diabetic client attending OPD of selected hospital with selected socio-demographic variables is accepted. Conclusion On the basis of finding of the study following conclusion can be drawn. It was found that among diabetic patient have less knowledge regarding self-administer of insulin injection.

Knowledge, attitude and practice of self-administered insulin by diabetes mellitus patients: A cross sectional study

Diabetes mellitus is a heterogeneous clinical syndrome secondary to defects in insulin secretion, action, or both. India is emerging as the world's diabetic capital. Inadequate awareness about the use of insulin is likely to influence its acceptance and adherence. To assess the knowledge, attitude, and practice (KAP) of self-administered insulin by patients of diabetes mellitus. It was a cross-sectional study conducted by the department of pharmacology at a tertiary care teaching hospital over a period of six months at the medicine outpatient department. A prevalidated questionnaire was used to assess the KAP of insulin use. Informed consent was obtained from the patients prior to giving them a questionnaire. Among the 151 responses, 58 were male and 93 were female. Among them, 66% knew about different types of insulin, and 32% knew about different insulin delivery devices. Around 40% of patients were not aware of HbA1c as a monitoring tool. Nearly 48% patients knew the complications of diabetes. Half of the patients were confident about the self-administration of insulin. About 54% patients took insulin for treatment. Among current insulin users, 75% injected insulin at the upper arm, 83% missed insulin doses, 74% had never used a glucometer, and 32% failed to rotate the site. Knowledge and attitude were good in the majority of patients, but practice regarding the use of insulin was poor. Skilled health care providers could educate diabetes mellitus patients on self-care management and insulin self-therapy and bridge this gap.

Does the implementation of self-administration policies for insulin improve patient safety in the hospital inpatient setting? A scoping review

Abstract Introduction Self-administration schemes can have significant impact on a patient’s management and treatment of specific diseases. Implementing the self-administration of insulin for inpatients is believed to increase patient’s knowledge, understanding, independence and confidence regarding medication to improve outcomes. This study identifies the limited knowledge and access to self-administration schemes for diabetes. Aim The aim of this scoping review is to collect and review relevant literature surrounding inpatient insulin self-administration schemes and to identify the impact this scheme has on knowledge, confidence, independence, satisfaction, costs and workload for patients, hospitals and staff. This scoping review further aims to highlight the reported limitations regarding self-administration and identify the potential gaps in the evidence-base. Methods Keywords were searched on MEDLINE (1946 to October Week 4 2022), EMBASE (1974 to 2022 Week 43), Scopus, Web of Science, CINAHL and Google Scholar from October 6th, 2022, to November 8th, 2022. The title, abstract and citations were initially screened using the inclusion and exclusion criteria. Included literature was then screened by a second reviewer. The identified literature described and evaluated inpatient insulin self-administration schemes and summarised according to author and study design. This scoping review did not require ethical approval as it was including information and studies freely available for public domain. Newcastle University Pharmacy Department. Results Among the 1,159 literature sources identified, 16 literature sources were included in the scoping review. A systematic review and meta-analysis was initially considered but yielded due to the heterogeneity of literature in study design. Nine quantitative and seven qualitative studies assessed individual patient and staff views. They were assessed in ranging time frames up to eight months. Literature evaluated the knowledge, understanding and compliance of patients relating to administration and drug regimens which were measured via questionnaires and interviews. Studies identified short-term costs to outweigh long-term benefits. The majority of patients and staff were significantly satisfied with the implementation of self-administration schemes. Discussion/Conclusion The implementation of insulin self-administration schemes for inpatients has shown to support patient health and safety, increasing knowledge and compliance. Literature continues to identify the need for extra support and maintenance from healthcare professionals to control diabetes. Self-administration schemes may continue to advance with increased support and engagement. Study limitations were identified to further acknowledged the advancements in time frames, support and sample size and selection for participants, supporting the advancements in self-administration schemes.

A Study to Assess the Effectiveness of Structured Teaching Programme on knowledge of Skill Associated to Self-Administration of Insulin among Gestational Diabetic Women Attending different hospitals of District Budgam, Kashmir

Gestational Diabetes Mellitus (GDM) is a form of diabetes occurring during pregnancy which can result in short- and long-term adverse outcomes for women and babies. GDM is carbohydrate intolerance resulting in hyperglycemia with onset or first recognition during pregnancy. Accurate diagnosis allows appropriate treatment. A pre experimental one group pre-test post-test design with non-probability purposive sampling technique was used.

Factors associated with Adherence to Insulin Self-Administration among Children and Adolescents with Type 1 DM in Iraq

Abstract Adolescents and children with type 1 diabetes have been reported to have challenges regarding adherence to treatment regimens compared with other age groups with diabetes. The study aimed to determine the level of commitment and investigate the effects of different factors on insulin adherence in type 1 diabetes patients in Iraq. This cross-sectional study included face-to-face interview questionnaires with caregivers of children and adolescents. Interviews were conducted in the Specialized Center of Endocrinology and Diabetes in Nasiriyah City, Iraq, from October 4, 2022, to March 30, 2023. The adherence questionnaire consisted of two sections; each consisted of five questions, including insulin and blood glucose recommendations. Blood samples were obtained from the patient to determine fasting blood glucose (FBG) and glycated hemoglobin (HBA1c)—results: 180 patients (86 males and 94 females) with type 1 DM. The mean age, weight, and disease duration were 10.75 (4.36) years, 36.30 (16.41) kg, and 6.24 (3.70) years, respectively. They had uncontrolled blood glucose (208.42 95.0 mg/dl) and HBA1c (9.90 2.85%). The patients (52.2%) were girls with primary school qualifications (43.3%). Most of the caregivers (parents and guardians) were either illiterate (30.6%) or had completed primary school (33.9%). In addition, the patient's families (43.9%) had low income (0.5 million ID cards). Therefore, most patients (60%) did not visit a doctor regularly or check their blood glucose. Adherence in the studied population could be higher. Focusing on raising their patients' awareness is pivotal to enhancing their medication adherence to reduce their short- and long-term diabetic complications, improve blood glucose control, and improve clinical outcomes. Keywords: Diabetes, Adherence, Insulin self-medication, Iraqi patients.

Perception and attitude of type 2 diabetic patients toward insulin therapy in the primary care of National Guard for Health Affairs (NGHA) in Jeddah, Saudi Arabia.

Our study explores and determines the perception toward insulin among patients with diabetes in the National Guard for Health Affairs (NGHA), Jeddah, the Kingdom of Saudi Arabia (KSA), and aims to gain insight into the causes of refusal. Patients with type 2 diabetes (T2D) are likely to need the use of insulin to keep blood glucose levels within normal range and delay the onset of diabetes-related problems. Individuals with diabetes may be hesitant to begin insulin therapy if they have a negative attitude toward it, which might add to the delay in beginning treatment. A cross-sectional study was conducted in the primary healthcare centers of the NGHA in Jeddah, Saudi Arabia. Data were collected through a validated self-administered questionnaire that was divided into three sections, with a total of 32 questions. The first section concerned demographic data, the second part was directed toward insulin users, and the last section was directed toward non-insulin patients. Our study collected 314 responses. Males constituted 54.8% of participants and insulin users resembled 45.7%. According to our study, important deterrents to starting insulin therapy among non-insulin users included the following: the cost of insulin, the pain associated with injections, the difficulty in maintaining food control while on insulin treatment, scarring at the injection site, and the weight gain impact. Factors that were found to influence compliance to insulin therapy among insulin users included fear of weight gain and self-administration of insulin.

SAT166 Elevated Insulin Autoantibody During COVID19 Illness Associated With Significant Hypoglycemia In A Type 1 Diabetic

Abstract Disclosure: D.A. Shewmon: None. D.C. Preston: None. Background: Insulin antibodies are a rare cause of hypoglycemia in diabetes mellitus type 1 (DM1). Exacerbation of this phenomenon by COVID-19 has not been previously reported. Clinical Case: A 46 year old, 60 kg female with DM1 of 19 year duration with hypoglycemic unawareness and retinopathy, who was admitted for flu-like symptoms, a blood glucose of 600 mg/dL in the absence of DKA, and COVID-19 by RT-PCR test. Hospitalization was complicated by 48 hours of hypoglycemia in the absence of insulin treatment, requiring continuous 10% dextrose infusion. Four months earlier the patient had been admitted for an undiagnosed non-COVID flu-like illness, with hypoglycemia for 60 hours in the absence of insulin treatment. Her glucose control was stable on 5 units of insulin per day at five and nine days after admission, and 25 units per day at 35 days after admission. At both admissions, the workup included a normal cortrosyn stimulation test, an undetectable C-peptide, a normal IGF-2 level, and a careful investigation to rule out evidence for self-administration of insulin. However insulin antibodies were elevated at 1.17 +/- 0.56 U/mL (n=4, normal <0.4) during the non-COVID illness, and 5.0 U/mL and 5.4 U/mL, during and 35 days after the COVID-19 illness, respectively. Thus insulin antibodies were 13 times the upper limit of normal during COVID-19 illness versus 2.9 times the upper limit of normal during the non-COVID-19 illness. Viral infection is one of the most significant environmental factors that may cause overstimulation of the immune system and has been shown to be associated with autoantibody generation and increase, in addition to autoimmune diseases. Known cytokine profiles on COVID-19 infections include IL-1, IL-6, IL-12, IFN-gamma, and TNF-alpha. The presence of IL-1 and TNF-alpha in particular, are known to be key pro-inflammatory cytokines in myriad autoimmune disorders. In vitro data suggest that IL-1 is also an important effector cytokine in DM1, through a number of direct (i.e., beta cell toxicity) and indirect means (i.e., by marking beta cells for Fas-dependent destruction by autoreactive cytotoxic T-lymphocytes). Conclusion: Our data could represent another example of the exacerbation of autoimmunity associated with COVID-19. The increases in the incidence of both autoantibodies and autoimmune diseases seen with COVID-19 suggest one of the conceptual frameworks for creating hypotheses regarding the nature of the Long COVID syndrome. Presentation: Saturday, June 17, 2023

How Common are the Errors in Insulin Injection Techniques – A Real World Study

Background: Insulin therapy is identified as the cornerstone of diabetes management for more than a century. Even though awareness programs on correct insulin administration have occupied the mainstream of diabetes management interventions, the prevalence of insulin injection errors among people with diabetes is significant in its count. Aims and Objectives: The current study evaluates the prevalence of various insulin injection errors among people with type 2 diabetes. Materials and Methods: The study employed a survey-based cross-sectional design to analyze the prevalence of insulin injection errors. The data was collected from people with T2D visiting the Outpatient Department (OPD) of four comprehensive diabetes research centres in Kerala, India. The inclusion criteria for the study include people with type 2 diabetes. The exclusion criteria included people with other types of diabetes, people with newly diagnosed T2D, and people with T2D who were insulin pump users. Demographic characteristics of the cohort were determined. The common errors in the injection administration were identified and the frequency of each error was determined. Data for the variables including, site selection, cleaning of needle and lipohypertrophy were collected. The categorical variables considered for the study was summarized as frequency (%) and all the continuous variables were presented as mean (SD) or median (Q1, Q3) based on the normality assumption. All the tests were carried out at a level of significance of 5 % using R version 4.2.3. Results: The common errors identified among the study cohort include incorrect site selection, inappropriate storage temperature, cleaning of the needle with spirit, hypoglycemia due to incorrect administration of insulin, and the presence of lipohypertrophy. Conclusion: The findings from the study underline the varied types of errors in the self-administration of insulin among the different age groups of the diabetes population and urge the health-care professionals to impart continuous review of the injection procedures patients follow while taking insulin injections

DIFFICULTIES RELATED TO INSULIN SELF-INJECTION

This study aimed to identify the main difficulties related to self-injection of insulin. This is a literature review, with a qualitative approach, of a descriptive nature, carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) tool, through the online search of national and international studies, in the period of July from 2023 to August 2023. Based on eligibility for the review, a total of 8 articles were selected for the study. According to the articles selected and analyzed, it is observed that the main difficulties are knowing the dosage, homogenization, lack of concrete information about this process, storage of the medicine and acceptance of the disease. The application of insulin was the most found in the studies, which is related to pain and fear, so this fact reflects on the patient’s self-confidence in managing their condition and consequently impairing their quality of life. Therefore, health professionals play an important role in the self-management of patients with diabetes, since support for self-administration of insulin is a necessary component in the care of people with chronic diseases.

Patient education on self-administration of insulin via pen: An interprofessional team-based educational initiative

Diabetes self-management necessitates an interprofessional approach, whereby members of the healthcare team reinforce patient education to ensure confidence and effective care. While insulin is administered by needle and syringe in the inpatient setting, patients at our institution may be prescribed insulin for self-administration via pen device upon discharge, necessitating that nurses be confident in providing patient education on the proper use of such devices. To address this educational need, pharmacists at our institution worked collaboratively with nurses and nurse educators to develop a nursing education module intended to improve nursing confidence and knowledge of insulin self-administration via pen device. A multi-modal educational approach, encompassing a didactic in-service presentation coupled with a hands-on demonstration and optional simulation assessment were utilized, in accordance with findings from previous studies. Change in learner confidence, knowledge and performance were measured. This interactive education module was found to be effective at improving nursing staff knowledge of key aspects associated with proper use of insulin via pen. This module can be replicated on other units or by other institutions seeking to improve patient education on self-administration of insulin via pen.

483 A realist review of inpatient insulin self-administration policy interventions for people with diabetes in hospital

Abstract Introduction Self-administration of insulin in hospital is recommended by Diabetes UK and NHS Improvement to improve patient outcomes, empower patients to self-care, reduce costs and facilitate better use of resources (1). The availability and use of policies to facilitate self-administration across NHS hospitals varies, therefore further exploration is needed regarding their use (2). As self-administration policies are a ‘complex intervention’, exploration should include elucidation of contextual factors that make the design, implementation, and use of these policies successful. Aim To discover what works, for whom, in what circumstances, in relation to the implementation of inpatient insulin self-administration policies. Methods A realist review was conducted to produce programme theories that uncovered the contexts and mechanisms by which self-administration policies are likely to be effective. Theories were developed iteratively using a combination of retroductive theorising, literature searching (Fig. 1) and stakeholder group consultation. Literature reviews included all evidence types published in English; references that failed realist quality assessment were excluded. Data were extracted and coded to programme theories to aid development using NVivo. Results were analysed using Normalisation Process Theory and Kanter’s theory of structural empowerment as a conceptual framework. The RAMESES standards were used to guide study conduct and reporting, and the protocol was published in the PROSPERO register. Ethical approval was not required. Stakeholder involvement throughout ensured that results remained grounded in the practical reality experienced by a range of participants and enhanced the usability of actionable findings. Figure 1: Overview of iterative literature searches and review process. Results Ten refined programme theories, presented as context-mechanism-outcome hypotheses resulted from the review Theories involved patient empowerment, shared-decision-making, shared responsibility, equalising power dynamics, correcting misconceptions, staff support and managing anticipated work burden. Contexts that facilitated positive outcomes included assigning a dedicated project lead, requisite governance considerations, multidisciplinary and patient collaboration, as well as clarification of responsibilities. Conclusion This review resulted in high-level principles to help guide context-specific organisational change and implementation of insulin self-administration policies for benefit of patient safety and satisfaction. Limitations include the complexity and arduousness of the process, requiring experience in realist theory, current practice, academia and policy implementation.

Knowledge' assessment of insulin self-administration in diabetic patients at Diabetes Health Centers, Baghdad, Iraq

Objective: To assess knowledge regarding insulin self-administration among diabetic patients in Baghdad City. Methodology: This descriptive cross-sectional study included a sample of 90 patients with diabetes mellitus on insulin therapy attending clinic of outpatients at National Diabetes Center of Al-Mustansiriya University and Specialized Center for Endocrine Disorders and Diabetes in Al-Russafa Health Directorate. The data were collected from March 15 to April 30, 2021. Results: The study’s participants had average information about diabetes, insulin and insulin self-administration. They got information from health personnel, personal experience, relatives, and internet. More than half of participants (53.3%) had normal level of knowledge about insulin self-administration. Conclusion: This study showed differences in patients’ knowledge about insulin self-administration. Focusing on their knowledge's improvement is essential to enhance their practice. Health education must be provided by physicians through counselling patients at each follow up visit.

Difficulties presented by patients with diabetes in self-administration of insulin: scoping review

Difficulties presented by patients with diabetes in self-administration of insulin: scoping review

PSUN278 Factitious hypoglycemia, diagnostic delay due to insulin assay failure to detect insulin analogues.

Abstract Factitious hypoglycemia may be difficult to diagnose clinically. Hypoglycemia due to insulin self-administration is established by the presence of a low c-peptide and elevated plasma insulin levels. Commercial insulin assays often fail to detect insulin analogs and can create confusion among providers investigating causes of hypoglycemia. A 20 year old female with no significant past medical history presented to an Emergency Room (ER) with hypoglycemia. She was treated with a single dose of octreotide 150 mcg, dexamethasone 10 mg PO and started on a D10W drip at 100ml/hr prior to transfer. Laboratory studies on transfer reported plasma glucose 52ng/dL (RR: 70-100), low C-peptide 0.02 (RR: 0.78-5.19), low insulin level <0.087 uIU/mL, normal IGF-I level 122 ng/mL (RR: 85-370). Normal IGF-II level 401 ng/mL (RR: 333-967), and low Pro-insulin level 1.8 pmol/L (RR: 3.6-22 pmol/L). Sulfonylurea Screen was negative. The patient and her mother both denied exogenous insulin use. The patient and her mother both work in healthcare. The patient's boyfriend has type 1 diabetes mellitus and the patient stated she keeps insulin in her purse for him. The patient was admitted for a 72 hour fast and remained normoglycemic. An aliquot of the admission ER insulin blood sample was sent to second laboratory utilizing an assay able to detect analog insulins. The patient's sample previously reporting an undetectable insulin level (<0.087 uIU/mL) now reported an insulin level 8 uIU/mL. Factitious hypoglycemia is a challenging clinical diagnosis. The term factitious implies an attempt to deceive and creates mistrust between the physician and patient. However, hypoglycemia may be the result of medication errors or administered by a second party with the intent to harm. Analog insulins (glargine, aspart, lispro, glulisine, etc) are genetically modified insulins developed to mimic the physiologic pattern of pancreatic beta cell insulin secretion. The amino acid modifications in analog insulins result in structural variations which alters the ability of highly specific commercial automated immunoassays to accurately quantitate these analog insulins. The variation in lab assay detection may cause confusion when interpreting the results. The DiaSorin Liaison XL platform in our hospital utilizes a chemiluminescence immunoassay which does not detect insulin analogs, but detects regular and NPH insulin as they are structurally identical to endogenous human insulin. The second laboratory uses the Siemens Advia Centaur platform, an immunoassay which reacts with insulin analogs "on a nearly equimolar basis with the analogs insulin aspart, insulin glargine, and insulin lispro. Insulin detemir exhibits approximately 50 percent cross-reactivity. Test reactivity with insulin glulisine is negligible (< 3 percent)". Many commercial insulin assays do not detect analog insulins and none qualitatively distinguish between different insulins. Failure to recognize this detection flaw may result in misdiagnosis, patient safety issues and costly unneeded additional studies Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Descriptive Study to Assess the Knowledge Regarding Self Administration of Insulin Injections

Introduction: Diabetes mellitus usually called diabetes sugar condition that occurs when the ones body does not produce insulin or body is enable to use normal amount insulin properly. Objectives: The objectives of the study where on asses the knowledge and practice regarding the diabetes patient. Design: a descriptive survey approach to assess the knowledge regarding self administration of insulin among the diabetes mellitus patient. Tool: using 15 items questionnaire was in known portability conversing sampling technique the sample setting is selected area of kansarakui. Sample Size: the sample size was 40. Result: The study identify the 17 patient (42.55) having good, 16(40%) have average, and (17.5) poor knowledge administration of insulin among diabetes patient.

Hypoglycémie factice à l’adolescence: un diagnostic à évoquer

Factitious hypoglycemia usually results from voluntary self-administration of insulin constituting a real metabolic emergency. Unresolved, it can lead to permanent brain damage and death. We report the case of a 17 years old female adolescent with factitious hypoglycemic episodes following inappropriate administration from an insulin pump. The interest of the case lies in its psycho-organic intricacies, constituting a real diagnostic and therapeutic challenge.

A Descriptive Study to Assess the Knowledge and Practice Regarding Insulin Self-Administration among Diabetic Patients at Elected Tertiary Care Hospital of Bangalore

Objective: To assess the knowledge and practice regarding self-administration of insulin in diabetic patients. Methodology: A cross sectional study was conducted among 100diabetic patients, on insulin therapy, attending medical and endocrine OPD's of tertiary hospital at Bangalore. Result: The result of the study showed that majority of the patients (56.67%) had average knowledge and 55% had average practices regarding insulin administration. Conclusion: There is a need to educate the patients diagnosed with diabetes about insulin self-administration and monitor their practice regarding same in hospital setup. This will improve their compliance and practices related to the self-administration of insulin and also prevent complications related to insulin therapy. Keywords: knowledge and practice, self-administration of insulin, diabetic patients.