Practice of insulin injection techniques among persons with diabetes in central India: an observational survey

Background: Correct injection technique used by the patient can determine the outcomes with insulin therapy in type 2 diabetes mellitus, however most patients on insulin remain unaware of the proper insulin injection techniques. The purpose of this study was to assess the current practice of insulin administration among diabetes patients.Methods: This cross-sectional study was conducted in 3 tertiary care centers delivering specialized diabetes care in central India from November 2019 to February 2020. The study included patients (n=150) using insulin for at least three months by either syringe or pen. All of them answered a survey questionnaire which focused on key insulin injection parameters.Results: Abdomen was the most common (53.33%) site of insulin injection. About 95.33% of subjects were following the injection site rotation instructions. The practice of hand washing, and cleaning of the injection site was practiced by 120 (80%) and 112 (74.66%) respondents respectively. Needle reuse was a common practice, and 146 (97.33%) subjects were using the same needle more than once. Around 73.33% were storing insulin at proper temperature, while 54.66 % reported having pain at the injection site and 14.66% had noticed persistent swelling at their injection sites. Conclusions: There is a significant gap between the insulin administration guidelines and current insulin injection practice. Education and counseling about proper insulin injection techniques should be provided to all persons with diabetes to ensure optimal usage of the drug to achieve the desired glycemic control.