
Manash P Baruah
Apollo Excelcare Hospital, IndiaTitle: Insulin injection practices amongst T2DM patients from India
Abstract
Substantial numbers of poorly controlled type 2 diabetes mellitus (T2DM) patients require
insulin. However,
insulin
injection practices and usage vary widely. We did this cross-sectional
retrospective registry study in an urban referral clinic in North East India including 1454 T2DM patients (60% male and 40% female) on insulin therapy, whose insulin utilization pattern and
injection techniques were audited. The mean duration of T2DM was 12.13 (7.45) years at enrolment.While 47.73% were treated
with insulin alone, 52.27% received other oral antidiabetic drugs(OAD) along with insulin. Majority (62.93%) used Pen device for insulin
administration was used by
majority(62.93%). The patient-reported main reasons for insulin therapy initiation were OAD failure (33.15%),
glucotoxicity (30.26%) and diabetes associated complications (20.36%), as reported by
patients. About 2/3rd had
HbA1c > 8%. Mean±SD total daily
dose of insulin
was 33.05±17.09units (0.53 ±0.30units/kg/ day). Majority (67.88%)used premixed insulin, while smaller basal
insulin users were in much smaller numbers(10.90%). With regard to injection practices, patients with
lipohypertrophy were less likely to rotate the site of injection (0.85 vs.
17.90%; p = 0.000), space the injections (10.71 vs. 23.91%; p = 0.000),
injected less often in right site (7.81 vs. 29.0%; p = 0.000), more likely to
use wrong angles (10.08 vs. 22.73%; p = 0.000) and reuse the needles (5.63 vs.
14.86%; p = 0.000). 8.87% of patients had experienced
at least one episode of hypoglycemic event during preceding 6 moths . This
audit reflects the current injection
practices amongst T2 DM patients, highlights the faulty ones, suggests
the benefits of adopting correct practices for avoiding complications such as
lipohypertrophy and hypoglycemia.
Biography
Manash P Baruah is currently the Promoter director, HOD, Department of
endocrinology,Apollo Excelcare hospital, Guwahati, India. He has >200 publications (
originals, reviews, editorials, abstracts), >5,000
citations and 25 consensus/ clinical practice guidelines. He has also
delivered >400 lecture in various international and national forums. He has served
in the editorial boards and reviewer panels of various reputed indexed
journals. He has been actively involved in clinical research and has served/is
serving as Principal
investigator/National Advisor for
studies such as LEADER(Liraglutide CVOT phase3b), ARISE(IDegAsp phase 4),
DUAL(IDegLira phase 3), SOUL( Oral Semaglutide CVOT phase 3b), Combine2(
IcoDegSema phase 3).