Evidence mapPaperPMID 32595768Full record

ArticleEuropean endocrinology2020

Insulin Injection Practice and Injection Complications - Results from the Bangladesh Insulin Injection Technique Survey.

Abm Kamrul-Hasan, Ajit Kumar Paul, Mohammad Nurul Amin, Md Abu Jar Gaffar, Md Asaduzzaman, Mohammad Saifuddin, Marufa Mustari, Md Jahangir Alam, Mohammad Moin Shahid, K M Nahid-Ul-Haque and 9 more

Open access · diamondAbstract read
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 52 citations in OpenAlex.

  1. Pen Needle Reuse in People with Diabetes Who Inject Insulin: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026
    Review
  2. Article
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  5. Observational
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  9. Addressing Insulin Injection Technique: A Follow-up Study of Canadian Patients with Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023
    Article
  10. Article
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  13. 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 · 2023
    Article
  14. Article
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  18. How to Minimize the Pain of Local Anesthetic Injection for Wide Awake Surgery.Plastic and reconstructive surgery. Global open · 2021
    Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 11 institutions in 1 country.

Abm Kamrul-HasanDepartment of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh.
Ajit Kumar PaulDepartment of Endocrinology, Mainamoti Medical College, Cumilla, Bangladesh.
Mohammad Nurul AminDepartment of Endocrinology, Mugda Medical College, Dhaka, Bangladesh.
Md Abu Jar GaffarDepartment of Physiology, Naogaon Medical College, Naogaon, Bangladesh.
Md AsaduzzamanDepartment of Endocrinology, Shaheed Sheikh Abu Naser Specialized Hospital, Khulna, Bangladesh.
Mohammad SaifuddinDepartment of Endocrinology, Dhaka Medical College, Dhaka, Bangladesh.
Marufa MustariDepartment of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Md Jahangir AlamDepartment of Endocrinology, Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh.
Mohammad Moin ShahidDepartment of Endocrinology, Ad-Din Women's Medical College, Dhaka, Bangladesh.
K M Nahid-Ul-HaqueDepartment of Endocrinology, Diabetic Association Medical College, Faridpur, Bangladesh.
Muhammad Shah AlamDepartment of Medicine, Army Medical College, Cumilla, Bangladesh.
Md Motiur RahmanDepartment of Medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh.
Samir Kumar TalukderDepartment of Endocrinology, Rangpur Medical College, Rangpur, Bangladesh.
Md Abdul KaderDepartment of Endocrinology, Diabetic Association Medical College, Faridpur, Bangladesh.
Farhana AkterDepartment of Endocrinology, Chittagong Medical College, Chittagong, Bangladesh.
Mohammad Abdul HannanDepartment of Endocrinology, North East Medical College, Sylhet, Bangladesh.
Palash Kumar ChandaDepartment of Endocrinology, Mymensingh Medical College, Mymensingh, Bangladesh.
Muhammed Abu BakarDepartment of Endocrinology, Chattogram Maa-Shishu O General Hospital, Chittagong, Bangladesh.
Shahjada SelimDepartment of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Dinajpur Medical College · BDBangabandhu Sheikh Mujib Medical University · BDDhaka Medical College and Hospital · BDMymensingh Medical College Hospital · BDChattagram Maa-O-Shishu Hospital Medical College · BDChittagong Medical College · BDComilla Medical College · BDMugda Medical CollegeNorth East University · BDRajshahi Medical College · BDShaheed Suhrawardy Medical College · BD

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Diabetesinjection techniqueinsulin educationinsulin injectionlipohypertrophy

Identifiers

PMID32595768
PMCPMC7308099
OpenAlexW3018861157

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.