Endocrine Abstracts

Introduction

Diabetes is a chronic disease and a public health problem. Insulin Injection is used as a treatment for type 1 diabetes and insulin-requiring type 2 diabetes. A well-made injection is the key to a good glycemic balance. However, many studies showed that diabetic patients did not master the injection technique, reflecting an empirical random or non-existent therapeutic patient education(TPE). Our objectives were to assess our patients’ knowledge of injection technique, to identify factors associated with glycemic balance and pain.

Methodology

This is a cross-sectional and descriptive study involving 50 diabetic patients (DT1: 40%, DT2:60%) insulin-treated recruited from the endocrinology department of the military hospital of Tunis, based on a questionnaire inspired by validated questionnaire proposed by Francophone Society of Diabetes(SFD) for the evaluation of the acquired knowledge of diabetic patients. The assessment of pain was carried out by the visual analogue scale(VAS).

Results

Our population was predominantly male (sex ratio 1.27). The mean age was 56.4 ± 19.4 years. The mean duration of diabetes was 13.3 with an average HbA1c of 10.2%. Insulin therapy averaged 7.4 ± 5.5 years (22% bed time, 36% basal, 42% basal/bolus). The mean number of daily injections was 3 with extremes ranging from 1 to 6. Thirty-three patients received an education mainly on themes of ’insulin conservation’ (78.8%) and ’choice of injection site’ (63.6%). Deficiencies mainly concerned the rotation of injection sites (20%), the search of lipodystrophies (14%), the practice of skin fold (48%), the reuse of needles (86%), and the unsafe waste disposal (94%). Glycemic balance was associated with rotation of injection sites(P = 0.01) and the practice of skin fold(P = 0.01). The presence of pain and its intensity were associated with the average number of injections per needle (P = 0.04 and P = 10³ respectively).

Conclusion

The role of caregivers is essential in the TPE of diabetic patients. However, they must be trained in this mission and guided through a pre-established program.