Abstract:
Majority of patients who are on insulin therapy do self-administration of their daily insulin doses subcutaneously. Proper insulin administration technique is crucial in delivery of the prescribed dose. This study aimed to evaluate insulin self-administration practices among patients who were treated with insulin. A descriptive cross-sectional study was conducted at the Diabetes and Endocrine Outpatient Clinic in a secondary healthcare setting in Sri Lanka. Patients with diabetes between 20 - 80 years of age who were on insulin therapy were recruited to the study sample (n = 200). A structured, content validated and interviewer-administered questionnaire was used to collect data related to socio-demography, clinical data and practices related to insulin self-administration. Data were analysed by SPSS version 26. p < 0.05 was considered statistically significant. Mean (±SD) age of the participants was 55 (±11) years. Majority (73.0%) were females. 94.0% (n = 188) were in low-income category. Of the participants 36.5% (n = 73) were treated with insulin for > 5 years. All participants cleaned hands prior to the injection and 86.5% cleaned the injection site before injection. Approximately 36.5% always injected insulin to the abdomen. About 35.5% did not make a skinfold when injecting insulin subcutaneously and 54.5% injected insulin at an angle of around 45 degrees. 89.0% were reusing the needle. All the patients were taking their insulin dose shortly before meals and 31% sometimes missed the insulin dose. 50% of the patients stored insulin in the door of the refrigerator. In conclusion administering insulin always to the same site, not making a skin fold, reusing the insulin needle and missing insulin doses are the poor practices observed among patients who are self-administering insulin. These poor practices could fail the delivery of the expected insulin dose while increasing the risk of contamination and irritation in the injection site. Poor adherence could lead to therapeutic failure causing multiple complications. İmplementing education programmes to improve insulin self-administration practices will be helpful to enhance therapeutic outcomes in patients with diabetes.
