title: Injection technique practices in a population of Canadians with diabetes: results from a recent patient/diabetes educator survey.
abstract: OBJECTIVE
  A Canadian survey was undertaken to elucidate injection techniques in the population of the country with diabetes and to make appropriate revisions to the 2011 Canadian Forum for Injection Technique recommendations.
  
  
  METHODS
  The study involved 503 participants (25% with type 1 diabetes; 75% with type 2 diabetes) from 55 diabetes education centres across Canada. They completed a survey regarding injection technique (i.e. needle length, angle of insertion, incidence of lipohypertrophy, injection routine). Healthcare professionals at the centres also completed a survey regarding their patients' injection techniques. To be eligible for the study, participants had injected either insulin or a glucagon-like peptide-1 receptor agonist for at least 6 months prior to enrolment.
  
  
  RESULTS
  Varying lengths of needles were used for injections; however, 45.3% of participants had changed needle lengths since they had begun injecting. The vast majority of participants (80.4%) injected medication into the abdomen; 36.6% had no explicit injection routine, whereas 31.4% injected into the same site at the same time each day. Overall, 24.6% of patients observed lipohypertrophy at injection sites, while only 13.3% of diabetes educators observed the same complication.
  
  
  CONCLUSIONS
  The survey allowed for a greater understanding of the strengths and weaknesses of Canadian patients and clinicians in the treatment of diabetes, particularly with respect to injection practices and procedures.
authors.affiliation: Winnipeg Regional Health Authority, Health Sciences Centre, Winnipeg Diabetes Research Group, Department of Medicine, Section of Endocrinology, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: ldberard@gmail.com.
authors.forename: Lori
authors.initials: L
authors.lastname: Berard
authors.affiliation: Winnipeg Regional Health Authority, Health Sciences Centre, Winnipeg Diabetes Research Group, Department of Medicine, Section of Endocrinology, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Brett
authors.initials: B
authors.lastname: Cameron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007279:Injections, Subcutaneous / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000706:statistics & numerical data*
chemical_list: D007004:Hypoglycemic Agents
keywords: agonistes des récepteurs du GLP-1 (glucagon-like peptide-1); diabetes education; enseignement sur le diabète; glucagon-like receptor agonists; injection technique; insulin; insuline; lipohypertrophie; lipohypertrophy; technique d'injection