Worldwide Injection Technique Questionnaire Study: Population Parameters and Injection Practices.
From February 1, 2014, through June 30, 2015, 13,289 insulin-injecting patients from 423 centers in 42 countries took part in one of the largest surveys ever performed in diabetes. The goal was to assess patient characteristics, as well as historical and practical aspects of their injection technique. Results show that 4- and 8-mm needle lengths are each used by nearly 30% of patients and 5- and 6-mm needles each by approximately 20%. Higher consumption of insulin (as measured by total daily dose) is associated with having lipohypertrophy (LH), injecting into LH, leakage from the injection site, and failing to reconstitute cloudy insulin. Glycated hemoglobin values are, on average, 0.5% higher in patients with LH and are significantly higher with incorrect rotation of sites and with needle reuse. Glycated hemoglobin values are lower in patients who distribute their injections over larger injection areas and whose sites are inspected routinely. The frequencies of unexpected hypoglycemia and glucose variability are significantly higher in those with LH, those injecting into LH, those who incorrectly rotate sites, and those who reuse needles. Needles associated with diabetes treatment are the most commonly used medical sharps in the world. However, correct disposal of sharps after use is critically suboptimal. Many used sharps end up in public trash and constitute a major accidental needlestick risk. Use of these data should stimulate renewed interest in and commitment to optimizing injection practices in patients with diabetes.
Department of Endocrinology, Skane University Hospital, Malmö, Sweden.
Anders H
AH
Frid
BD Diabetes Care, Franklin Lakes, NJ.
Laurence J
LJ
Hirsch
University of Liege, Liege, Belgium.
Astrid R
AR
Menchior
BD, Le Pont de Claix, France.
Didier R
DR
Morel
BD Diabetes Care, Erembodegem, Belgium. Electronic address: kenneth_strauss@europe.bd.com.
Kenneth W
KW
Strauss
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007267:Injections / Q000379:methods*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries; D011795:Surveys and Questionnaires
D007004:Hypoglycemic Agents; D007328:Insulin