Turkish insulin injection techniques study: complications of injecting insulin among Turkish patients with diabetes, education they received, and the role of health care professional as assessed by survey questionnaire

Abstract

Introduction: Using the Turkish and rest of world (ROW) Injection Technique Questionnaire (ITQ) data we address key insulin injection complications. Methods: Summarized in first ITQ paper. Results: Nearly one-third of Turkish insulin users described lesions consistent with lipohypertrophy (LH) at heir injection sites and 27.4% were found to have LH by the examining nurse (using visual inspection and palpation). LH lesions in the abdomen and thigh of Turkish patients are slightly smaller than those measured in ROW but more than half of Turkish patients who have LH continue to inject into them at least daily. More than a quarter of Turkish patients have frequent unexplained hypoglycemia and nearly 2 out of 5 have glycemic variability, both of which have been linked to the presence of LH and the habit of injecting into it. Nearly half of Turkish injectors report having pain on injection. Of these, just over half report having painful injections only several times a month or year (i.e., not with every injection). In Turkey the diabetes nurse has by far the major role in teaching patients how to inject. Nearly 40% of Turkish injectors get their sites checked at least annually, and a larger roportion than ROW had received recent (within the last 12 months) instruction on how to inject properly. Conclusion: Turkish patients and professionals have clearly made progress in injection technique, but there are still considerable challenges ahead which the new Turkish guidelines will help address.