ArticleEuropean endocrinology2020
Insulin Injection Practice and Injection Complications - Results from the Bangladesh Insulin Injection Technique Survey.
Article in European endocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed, 52 citations in OpenAlex.
- Pen Needle Reuse in People with Diabetes Who Inject Insulin: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Review
- Skin-related adverse events and their associated factors among Diabetic patients on insulin therapy.PloS one · 2026Article
- Predictors of limited knowledge in insulin injection techniques among non-specialty nurses in Japan.SAGE open medicine · 2025Article
- Effectiveness of health education on insulin injection technique in patients with type 2 diabetes mellitus: A quasi-experimental Pre-test post-test research.Journal of family medicine and primary care · 2024Article
- Knowledge, attitude, and practice of insulin among diabetic patients and pharmacists in Egypt: "cross-sectional observational study".BMC medical education · 2024Observational
- Review
- Localization of the questionnaire about sharps disposal at home among diabetes based on knowledge, attitude, and practice theory, and a cross-sectional survey of current conditions.Frontiers in public health · 2024Article
- Errors in diabetic insulin therapy and the vitality of proper precautions in Bangladesh: Real-life insights from the developing world.Journal of family medicine and primary care · 2024Article
- Addressing Insulin Injection Technique: A Follow-up Study of Canadian Patients with Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023Article
- Development and validation of a distress measurement for insulin injections among patients with diabetes.Scientific reports · 2023Article
- Effect of a reused insulin needle remaining in a patient's body.Journal of diabetes investigation · 2023Article
- Insulin injection practice and health related quality of life among individuals with diabetes at Tikur Anbessa Specialized Hospital, Ethiopia: a cross-sectional study.Health and quality of life outcomes · 2023Article
- Development and Validation of a Distress Measurement Related to Glucose Monitoring of Diabetes Patients.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023Article
- Comparison of simplicity, convenience, safety, and cost-effectiveness between use of insulin pen devices and disposable plastic syringes by patients with type 2 diabetes mellitus: a cross-sectional study from Bangladesh.BMC endocrine disorders · 2023Article
- Investigation of Association Between Insulin Injection Technique and Blood Glucose Control in Patients with Type 2 Diabetes.International journal of endocrinology and metabolism · 2022Article
- Effect of Insulin Injection Techniques on Glycemic Control Among Patients with Diabetes.International journal of general medicine · 2022Article
- At-home disposal practices of used insulin needles among patients with diabetes in China: A single-center, cross-sectional study.Frontiers in public health · 2022Article
- How to Minimize the Pain of Local Anesthetic Injection for Wide Awake Surgery.Plastic and reconstructive surgery. Global open · 2021Review
- The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam.Journal of diabetes research · 2021Article
- The insulin sharps disposal study: Evaluation of a structured patient education initiative in an urban community health centre in India.Journal of family medicine and primary care · 2020Article
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19 authors at 11 institutions in 1 country.
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Abstract
introductionDiabetes mellitus is highly prevalent in Bangladesh and insulin is often needed for diabetes control. We lack sufficient data on the insulin injection technique and injection-related complications.
methodsThe Bangladesh Insulin Injection Technique Survey (BIITS) was conducted in 2018 in 18 centres throughout Bangladesh, involving 847 patients taking insulin for at least 6 months. All of the study subjects were interviewed using a structured questionnaire focusing on key insulin injection parameters.
resultsThe mean duration of insulin use by the study subjects was 3.84 (± 4.05) years and the mean daily dose of insulin was 41 (± 25) units. A total of 71.6% participants performed ≤2 injections/day and premixed insulins were the most commonly used insulins. Mean glycated haemoglobin (HbA1c) was 9.5% (± 2%). The proportion of syringe users and pen-device users was 68.1% and 31.9%, respectively. Most of the participants injected in the abdomen and rotated the injection site(s). The majority lifted the skinfold correctly and inserted the needle at a 90-degree angle, but their dwell times after injections were not adequate. A total of 9.2% of the subjects had injection-site lipohypertrophy (LH) and among them, 38.5% injected into the lesion. Patients with LH had higher HbA1c. Higher duration of insulin use (≥5 years), reusing needles more often (>10 times), and injecting at angles other than 90 degrees were independent predictors of LH. The incidences of hypoglycaemia (36.7%) and hyperglycaemia (67.4%) were very high, and subjects with LH had higher chances of both hypoglycaemia and hyperglycaemia. Though most (92.1%) of the patients received education about insulin injection initially, it was not repeated in the recent follow-up and was found to be ineffective.
conclusionA huge gap between the insulin administration guidelines and current practice was observed in this study. Complications of insulin injections were also common. Healthcare providers should pay more attention to insulin education and re-evaluate injection practices from time to time.
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