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The role of proper insulin injection technique training FOR achieving of good glycaemic control

https://doi.org/10.14341/DM9663

Abstract

Inappropriate injection technique leads to incorrect insulin dosing, increased pain and impaired glucose control in patients with diabetes. This review examines in detail the results of two clinical studies, the Glycemic Impact of Insulin Injection Technique (GIIIT) and the UK Lipo Study (UKLS) that examined the effect of teaching patients proper injection techniques to achieve good glycemic control.


The GIIIT study included patients with type 1 and type 2 diabetes (18–70 years) who were on a regimen of multiple daily insulin injections. They were categorised into three groups: those that received structured injection technique training using 4-mm injection needles (TN), those that received injection technique training (T) and control (C). The UKLS study included 75 patients who received structured training to reduce the risk of developing lipohypertrophy.


Initially, deviations from proper insulin injection technique were observed in a majority of patients in both the studies. In the GIIIT study, 6 months after training under TN and T conditions, HbA1c decreased by 1%, with no observable changes under the C condition. The daily insulin dose was increased by 6 IU in all conditions. Overall, the use of 4-mm short needles reduced post-injective pain in all patients. In the UKLS study, for 6 months, the variability of glycemia and frequency of unexplained hypoglycaemia decreased as the daily dose of insulin decreased by an average 6 IU; in addition, HbA1c level decreased from 8.6% to 8.2%. Six months after the training, both studies noted a decrease in or disappearance of lipohypertrophy in the patients.


These results indicate that proper injection technique training improves glycemic control in patients with diabetes.

About the Authors

Inna V. Misnikova

Moscow Area Moscows regional research clinical institute n.a. M.F. Vladimirskiy


Russian Federation

MD, PhD, Professor



Valeriya A. Gubkina

Moscow Area Moscows regional research clinical institute n.a. M.F. Vladimirskiy


Russian Federation

MD, PhD



Alexander V. Dreval

Moscow Area Moscows regional research clinical institute n.a. M.F. Vladimirskiy


Russian Federation

MD, PhD, Professor



References

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Supplementary files

1. Fig. 1. Dynamics of HbA1c level for 6 months of research in different groups in the GIIIT study.
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Type Исследовательские инструменты
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2. Fig. 2. Changes in daily insulin dose in different groups of the GIIIT study.
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Type Исследовательские инструменты
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Review

For citations:


Misnikova I.V., Gubkina V.A., Dreval A.V. The role of proper insulin injection technique training FOR achieving of good glycaemic control. Diabetes mellitus. 2018;21(5):419-424. (In Russ.) https://doi.org/10.14341/DM9663

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ISSN 2072-0351 (Print)
ISSN 2072-0378 (Online)