title: Indian Injection Technique Study: Injecting Complications, Education, and the Health Care Professional.
abstract: BACKGROUND
  Using the Indian and rest of world (ROW) injection technique questionnaire (ITQ) data, we address key insulin injection complications.
  
  
  METHODS
  In 2015 we conducted an ITQ survey throughout India involving 1011 patients. Indian values were compared with those from 41 other countries participating in the ITQ, known here as ROW.
  
  
  RESULTS
  More than a quarter of Indian insulin users described lesions consistent with lipohypertrophy (LH) at their injection sites and approximately 1 in 5 were found to have LH by the examining nurse (using visual inspection and palpation). Just over half of Indian injectors report having pain on injection. Of these, 4 out of 5 report having painful injections only several times a month or year (i.e., not with every injection). Doctors and diabetes educators in India (as opposed to nurses) have a larger role in teaching patients how to inject than they do in ROW. Despite this specialized approach, a very high percentage of patients report that they have not been trained (at least cannot remember being trained) in a wide range of essential injection topics. Only about 30% of Indian injectors get their sites checked at least annually, with nearly a third only having sites checked when they specifically complained and nearly 4 out of 10 never having had their sites checked.
  
  
  CONCLUSIONS
  Indian HCPs can clearly do a better job covering all the vital topics essential to proper injection habits.
authors.affiliation: Bharti Hospital, Kunjpura Road, Karnal, India.
authors.forename: Sanjay
authors.identifier: http://orcid.org/0000-0002-1031-0067
authors.initials: S
authors.lastname: Kalra
authors.affiliation: Medanta the Medicity, CH Baktawar Singh Road, Sector 38, Gurugram, Haryana, India.
authors.forename: Ambrish
authors.initials: A
authors.lastname: Mithal
authors.affiliation: Osmania Medical College, Turrebaz Khan Rd, Esamiya Bazaar, Koti, Hyderabad, Telangana, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Sahay
authors.affiliation: Providence Endocrine and Diabetes Specialty Centre, TC 1/2138, Near GG Hospital, Murinjapalam, Thiruvananthapuram, Kerala, India.
authors.forename: Mathew
authors.initials: M
authors.lastname: John
authors.affiliation: Chellaram Diabetes Institute, Pune-Bangalore, NH4, Bavdhan, Pune, Maharashtra, India.
authors.forename: A G
authors.initials: AG
authors.lastname: Unnikrishnan
authors.affiliation: Diacare-Diabetes Care and Hormone Clinic, 1 and 2 Gandhi Park Society, Nehrunagar Cross Roads, Ambavadi, Ahmedabad, Gujarat, India.
authors.forename: Banshi
authors.initials: B
authors.lastname: Saboo
authors.affiliation: AMRI Medical Centre Kolkata, No. 97 A, Southern Avenue, Above Maruti Showroom, Opposite Lake Stadium, Kolkata, West Bengal, India.
authors.forename: Sujoy
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: KPC Medical College and Hospital, Kolkata, F, Raja Subodh Chandra Mullick Road, Jadavpur, Near Jadavpur Railway Station, Kolkata, West Bengal, India.
authors.forename: Debmalya
authors.initials: D
authors.lastname: Sanyal
authors.affiliation: BD Diabetes Care, 1 Becton Dr. MC 378, Franklin Lakes, NJ, USA.
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Hirsch
authors.affiliation: BD Diabetes Care, BD, 6th Floor Signature Tower-B, South City I, NH 8, Gurgaon, Haryana, India.
authors.forename: Vandita
authors.initials: V
authors.lastname: Gupta
authors.affiliation: BD Diabetes Care, POB 13, Erembodegem-Dorp 86, 9320, Erembodegem, Belgium. kenneth.strauss@bd.com.
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Strauss
keywords: Infusions; Injections; Insulin; Lipodystrophy; Lipohypertrophy; Needles; Needlestick; Subcutaneous