Investigation of Association Between Insulin Injection Technique and Blood Glucose Control in Patients with Type 2 Diabetes

Abstract

Background: The appropriate insulin injection skill is essential for optimal blood sugar control in patients with diabetes. However, the art of insulin injection is still not well understood in numerous medical centers. Objectives: This study was designed to determine the association between appropriate insulin injection and blood glucose control in patients with type 2 diabetes in Yazd, Iran. Methods: This cross-sectional study was conducted on 301 patients with type 2 diabetes who referred to Diabetes Research Center in Yazd within August 2020 to February 2021. Based on simple random sampling, the subjects with inclusion criteria, such as age >18 years, using an insulin pen for at least 3 months, and self-injection, were selected. The insulin injection technique was evaluated by a 13-item researcher-made questionnaire. The total score of this questionnaire was 26, and its validity and reliability were confirmed. The data were analyzed using SPSS software (version 20). Results: The mean age of the participants was 59.83 ± 10.26 years, and 60.1% had primary school or less education. Most participants (87%) used a needle more than five times, and almost half of them (53.5%) did not rotate the injection sites properly. The patients who reported pain during injection had statically lower injection scores than others (17.90 vs. 19.38, P = 0.001). There was a significant negative correlation between insulin injection score with fasting blood sugar (β = -0.232, P < 0.001), two-hour postprandial glucose (β = -0.164, P = 0.005), and hemoglobin A1c (HbA1c) level (β = -0.263, P < 0.001). Conclusions: None of the patients in this study fully followed the principles of a proper injection, which can lead to pain during injection, lipohypertrophy, hyperglycemia, and increased HbA1c levels.