Assessment of knowledge, attitude and practice of insulin injection among subjects with diabetes mellitus

Background: Diabetes mellitus (DM) is a spectrum of common metabolic disorders whose management mainly lies in treating the patients with oral hypoglycemic drugs and insulin along with the dietary and lifestyle modifications. Insulin is administered most subcutaneously. As the insulin injection sites are relatively painless, patients tend to inject in the same area repeatedly rather than moving to a newer site and increase risk for development of injection site reactions like lipodystrophy and impairment of glycemic control. Hence, it is utmost important for every diabetic patient and their relatives who would inject the insulin injection to be aware of appropriate manner of insulin injection. This helps in maintaining adequate glycemic control in diabetic patients. The main objective of this study was to assess the knowledge, attitude and practice of insulin injection technique among the diabetic patients.Methods: A cross-sectional study was conducted in the department of Endocrinology on 250 diabetic patients taking insulin injections based on inclusion and exclusion criteria. A validated questionnaire was administered to patients to answer in order to assess their knowledge, attitude and practice about technique of insulin injection.Results: In this study, it was found that 90% of the patients were aware of rotating the injection site, whereas only 40% of the patients were aware of appropriate time duration (5-10 sec for syringes/counting 1-15 for releasing the pen) required for resting the syringe/pen needle inside the skin. Only 48% of the patients used to remove the air bubble prior to injection, 57% pinched the injection site before injecting, 20% rubbed the injection site after injection and 30% used to wash hands prior to injection. Hypoglycemia was the most common adverse effect noted in 54% of patients.Conclusions: It can be concluded from the present study that every patient and his/her attendant needs to be educated and trained appropriately regarding technique of injecting insulin injection for betterment of their health.