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.

123

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