Zhou Tao, Zheng Yan, Li Juan, Zou Xiangjun
Department of Radiology, The First Hospital of Northwest University, Xi'an, Shaanxi, China.
Department of Urology, The First Hospital of Northwest University, Xi'an, Shaanxi, China.
J Eval Clin Pract. 2024 Nov 4. doi: 10.1111/jep.14226.
Appropriate insulin injection technique can help to enhance positive clinical outcomes in insulin-treated patients. This cross-sectional survey was undertaken to assess the present state of injection technique practices of patients administering insulin and the incidence of local complications associated with insulin injection.
This cross-sectional study was conducted at 11 tertiary hospitals in Xi'an City. A total of 1370 patients with diabetes were enroled in the survey. Each patient was asked questions on the Injection Technique questionnaire, demonstrated insulin injection on an injection training pad and had their injection sites inspected by a nurse.
About 98% of participants were type 2 diabetic patients. The 5 mm length needles were used by 640 (46.71%) patients. Around 1286 participants reused pen needles. Only one-third of patients rotate the injection sites. Around 901 patients had ecchymosis at injection sites, 43 participants suffered rash and or pruritus and 661 patients had lipohypertrophy. About 2.99% of patients reported having infection at the injection sites. Most patients (72.55%) occasionally felt pain when injecting insulin. The results of the multivariable logistict analysis showed that gender (male), needle length, priming the pen before injections and correct site rotation were negatively associated with the incidence of injection site ecchymosis. Lower incidence of lipohypertrophy was associated with needle length 4 mm, needle length 6 mm, single use of pen needles, priming the pen before injections and correct site rotation. Higher incidence of injection site infection was related to not disinfecting injection sites before each injection.
Despite some improvements detected in some aspects of patients' insulin injection practice in recent years, a large gap still exists between insulin injection guidelines and patients' actual injection behaviour. Injection-related complications at injection sites are still considerably common among our study population. Patients' education regarding insulin injection technique should be conducted repeatedly and regularly to make sure patients' compliance to injection guidelines.
恰当的胰岛素注射技术有助于提高接受胰岛素治疗患者的临床阳性结局。开展此项横断面调查以评估胰岛素注射患者的注射技术操作现状以及与胰岛素注射相关的局部并发症发生率。
此项横断面研究在西安市的11家三级医院进行。共有1370例糖尿病患者纳入调查。每位患者均被问及有关注射技术问卷的问题，在注射训练垫上演示胰岛素注射，并由护士检查其注射部位。
约98%的参与者为2型糖尿病患者。640例（46.71%）患者使用5毫米长的针头。约1286名参与者重复使用笔式针头。仅三分之一的患者轮换注射部位。约901例患者注射部位出现瘀斑，43名参与者出现皮疹和/或瘙痒，661例患者出现脂肪增生。约2.99%的患者报告注射部位有感染。大多数患者（72.55%）注射胰岛素时偶尔会感到疼痛。多变量逻辑回归分析结果显示，性别（男性）、针头长度、注射前预充笔以及正确的部位轮换与注射部位瘀斑的发生率呈负相关。脂肪增生发生率较低与4毫米针头长度、6毫米针头长度、笔式针头一次性使用、注射前预充笔以及正确的部位轮换有关。注射部位感染发生率较高与每次注射前未对注射部位进行消毒有关。
尽管近年来在患者胰岛素注射操作的某些方面检测到一些改善，但胰岛素注射指南与患者实际注射行为之间仍存在较大差距。在我们的研究人群中，注射部位与注射相关的并发症仍然相当常见。应反复且定期地对患者进行胰岛素注射技术教育，以确保患者遵守注射指南。
