Improvement of Glycemic Control by Re-education in Insulin Injection Technique in Patients with Diabetes Mellitus
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ORIGINAL RESEARCH
Improvement of Glycemic Control by Re-education in Insulin Injection Technique in Patients with Diabetes Mellitus Yuki Nakatani • Mihoko Matsumura • Tsuyoshi Monden
•
Yoshimasa Aso Takaaki Nakamoto •
To view enhanced content go to www.advancesintherapy.com Received: September 2, 2013 / Published online: October 30, 2013 Ó Springer Healthcare 2013
ABSTRACT
After answering questions about the insulin
Introduction: The aim of this study was to
injection technique, the patients’ knowledge levels were scored. Correct answers and
evaluate the effectiveness of re-education in the
explanation sheets were subsequently given to all
insulin injection control.
glycemic
patients. The physicians in charge gave a short lecture and provided 10 min of individual advice.
Methods: A preliminary experimental study was performed with 87 insulin-treated diabetic
Two, three, and four months after re-education the HbA1c and glycoalbumin levels were measured.
outpatients (11 with type 1 diabetes, 76 with type
Results: The mean HbA1c levels of almost all
2 diabetes; 43 men, 44 women). All patients had been treated with insulin for more than 3 years.
patients significantly improved from 7.46 ± 0.09% to 6.73 ± 0.10% (P\0.01), and
technique
for
Y. Nakatani Department of Diabetes and Endocrinology, Dokkyo Medical University Nikko Medical Center, Tochigi 321-2593, Japan M. Matsumura (&) T. Monden Y. Aso Department of Endocrinology and Metabolism, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan e-mail: [email protected] T. Nakamoto Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Tochigi 321-2593, Japan
the mean glycoalbumin levels significantly improved from 22.76 ± 0.50% to 20.26 ± 0.68% (P\0.01). Twenty-five patients demonstrated a poor understanding (score of B6 points) and showed a significant decrease in the HbA1c level from 7.62 ± 0.20% to 6.71 ± 0.21% (P = 0.02). Forty-three patients demonstrated a moderate understanding (score of 7 or 8 points) and showed a decrease in the HbA1c level from 7.40 ± 0.13% to 6.68 ± 0.07% (P = 0.07). Finally, 19 patients demonstrated a good understanding (score of C9 points) and showed a slight decrease in the HbA1c level from
Enhanced content for Advances in Therapy articles is available on the journal web site: www.advancesintherapy.com
7.38 ± 0.15% to 6.93 ± 0.12% (P = 0.09). Patients with a poor understanding showed the largest decrease in the mean level of HbA1c.
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Adv Ther (2013) 30:897–906
898
Conclusion: Re-education
in
the
insulin
instruction in self-injection is often only given
injection technique led to an improvement in glycemic control in insulin-treated diabetic
at the start of insulin treatment and often
patients, especially in those with a poor understanding of the insulin injection
patients cannot understand how to self-inject insulin perfectly [8]. Recently, there has been an
technique. More attention should be paid to
emergence of many patients with a long history of insulin
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