Turkish Insulin Injection Technique Study: Population Characteristics of Turkish Patients with Diabetes Who Inject Insulin and Details of Their Injection Practices as Assessed by Survey Questionnaire
Introduction Over 7 million people in Turkey have diabetes. Of the 1 million who inject insulin little is known of their habits and injection techniques. Methods We conducted an Injection Technique Questionnaire (ITQ) survey throughout Turkey that involved 1376 patients from 56 centers. Turkish valu...
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| Veröffentlicht in: | Diabetes therapy 2018-08, Vol.9 (4), p.1629-1645 |
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| creator | Dagdelen, Selcuk Deyneli, Oguzhan Olgun, Nermin Siva, Zeynep Osar Sargin, Mehmet Hatun, Sükrü Kulaksizoglu, Mustafa Kaya, Ahmet Gürlek, Cansu Aslan Hirsch, Laurence J. Strauss, Kenneth W. |
| description | Introduction
Over 7 million people in Turkey have diabetes. Of the 1 million who inject insulin little is known of their habits and injection techniques.
Methods
We conducted an Injection Technique Questionnaire (ITQ) survey throughout Turkey that involved 1376 patients from 56 centers. Turkish values were compared with those from 41 other countries participating in the ITQ, known here as Rest of World (ROW).
Results
The majority (50.4%) of Turkish insulin users give four injections/ day as opposed to ROW, where only 30.9% do. The abdomen is the most common injection site used by Turkish patients, but they also inject insulin in multiple body sites more often than do patients in ROW. Body mass index values in Turkey were 0.75 units higher than those in ROW as was the mean total daily dose (average daily dose [ADD]) of insulin (54.0 IU in Turkey vs. 47.4 IU in ROW). Mean glycated hemoglobin (HbA1c) in Turkey was 9.1%, which is higher than in ROW and possibly related to the higher BMI and ADD. Turkish patients use insulin analogs (short and long-acting) more frequently than do patients in ROW. The shortest pen needles (4 mm) are used by about one-third of patients in Turkey, but the longer ones (8 mm) are equally common. Needles are reused in Turkey at a rate of 3.4 injections/single needle. However, needle reuse, whether with pens or syringes, is lower in Turkey than ROW, as is the number of times a reused needle is used. More than 75% of used sharps in Turkey go into the rubbish, with nearly 6% having no protection of the tip.
Conclusion
The continued use of 8-mm needles raises the risk of intramuscular injections in Turkish patients. Despite full reimbursement, needle reuse still remains an important issue. More focus needs to be given to dwell times under the skin, reconstitution of cloudy insulant, correct use of skin folds and safe disposal of sharps.
Funding
BD Diabetes Care. |
| doi_str_mv | 10.1007/s13300-018-0464-7 |
| format | Article |
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Over 7 million people in Turkey have diabetes. Of the 1 million who inject insulin little is known of their habits and injection techniques.
Methods
We conducted an Injection Technique Questionnaire (ITQ) survey throughout Turkey that involved 1376 patients from 56 centers. Turkish values were compared with those from 41 other countries participating in the ITQ, known here as Rest of World (ROW).
Results
The majority (50.4%) of Turkish insulin users give four injections/ day as opposed to ROW, where only 30.9% do. The abdomen is the most common injection site used by Turkish patients, but they also inject insulin in multiple body sites more often than do patients in ROW. Body mass index values in Turkey were 0.75 units higher than those in ROW as was the mean total daily dose (average daily dose [ADD]) of insulin (54.0 IU in Turkey vs. 47.4 IU in ROW). Mean glycated hemoglobin (HbA1c) in Turkey was 9.1%, which is higher than in ROW and possibly related to the higher BMI and ADD. Turkish patients use insulin analogs (short and long-acting) more frequently than do patients in ROW. The shortest pen needles (4 mm) are used by about one-third of patients in Turkey, but the longer ones (8 mm) are equally common. Needles are reused in Turkey at a rate of 3.4 injections/single needle. However, needle reuse, whether with pens or syringes, is lower in Turkey than ROW, as is the number of times a reused needle is used. More than 75% of used sharps in Turkey go into the rubbish, with nearly 6% having no protection of the tip.
Conclusion
The continued use of 8-mm needles raises the risk of intramuscular injections in Turkish patients. Despite full reimbursement, needle reuse still remains an important issue. More focus needs to be given to dwell times under the skin, reconstitution of cloudy insulant, correct use of skin folds and safe disposal of sharps.
Funding
BD Diabetes Care.</description><identifier>ISSN: 1869-6953</identifier><identifier>EISSN: 1869-6961</identifier><identifier>DOI: 10.1007/s13300-018-0464-7</identifier><identifier>PMID: 29961245</identifier><language>eng</language><publisher>Cheshire: Springer Healthcare</publisher><subject>Cardiology ; Diabetes ; Diabetics ; Dosage and administration ; Drug therapy ; Endocrinology ; Injections ; Insulin ; Internal Medicine ; Medicine ; Medicine & Public Health ; Original Research ; Questionnaires ; Surveys</subject><ispartof>Diabetes therapy, 2018-08, Vol.9 (4), p.1629-1645</ispartof><rights>The Author(s) 2018</rights><rights>COPYRIGHT 2018 Springer</rights><rights>Diabetes Therapy is a copyright of Springer, (2018). All Rights Reserved.</rights><rights>The Author(s) 2018. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c565t-e00b366b155697c72f31dbe8dcbe702284cf3900ab548ac379c01154ec3c9bf03</citedby><cites>FETCH-LOGICAL-c565t-e00b366b155697c72f31dbe8dcbe702284cf3900ab548ac379c01154ec3c9bf03</cites><orcidid>0000-0002-1031-0067</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064578/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064578/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,41099,42168,51554,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29961245$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dagdelen, Selcuk</creatorcontrib><creatorcontrib>Deyneli, Oguzhan</creatorcontrib><creatorcontrib>Olgun, Nermin</creatorcontrib><creatorcontrib>Siva, Zeynep Osar</creatorcontrib><creatorcontrib>Sargin, Mehmet</creatorcontrib><creatorcontrib>Hatun, Sükrü</creatorcontrib><creatorcontrib>Kulaksizoglu, Mustafa</creatorcontrib><creatorcontrib>Kaya, Ahmet</creatorcontrib><creatorcontrib>Gürlek, Cansu Aslan</creatorcontrib><creatorcontrib>Hirsch, Laurence J.</creatorcontrib><creatorcontrib>Strauss, Kenneth W.</creatorcontrib><creatorcontrib>ITQ Turkish Study Group</creatorcontrib><creatorcontrib>the ITQ Turkish Study Group</creatorcontrib><title>Turkish Insulin Injection Technique Study: Population Characteristics of Turkish Patients with Diabetes Who Inject Insulin and Details of Their Injection Practices as Assessed by Survey Questionnaire</title><title>Diabetes therapy</title><addtitle>Diabetes Ther</addtitle><addtitle>Diabetes Ther</addtitle><description>Introduction
Over 7 million people in Turkey have diabetes. Of the 1 million who inject insulin little is known of their habits and injection techniques.
Methods
We conducted an Injection Technique Questionnaire (ITQ) survey throughout Turkey that involved 1376 patients from 56 centers. Turkish values were compared with those from 41 other countries participating in the ITQ, known here as Rest of World (ROW).
Results
The majority (50.4%) of Turkish insulin users give four injections/ day as opposed to ROW, where only 30.9% do. The abdomen is the most common injection site used by Turkish patients, but they also inject insulin in multiple body sites more often than do patients in ROW. Body mass index values in Turkey were 0.75 units higher than those in ROW as was the mean total daily dose (average daily dose [ADD]) of insulin (54.0 IU in Turkey vs. 47.4 IU in ROW). Mean glycated hemoglobin (HbA1c) in Turkey was 9.1%, which is higher than in ROW and possibly related to the higher BMI and ADD. Turkish patients use insulin analogs (short and long-acting) more frequently than do patients in ROW. The shortest pen needles (4 mm) are used by about one-third of patients in Turkey, but the longer ones (8 mm) are equally common. Needles are reused in Turkey at a rate of 3.4 injections/single needle. However, needle reuse, whether with pens or syringes, is lower in Turkey than ROW, as is the number of times a reused needle is used. More than 75% of used sharps in Turkey go into the rubbish, with nearly 6% having no protection of the tip.
Conclusion
The continued use of 8-mm needles raises the risk of intramuscular injections in Turkish patients. Despite full reimbursement, needle reuse still remains an important issue. More focus needs to be given to dwell times under the skin, reconstitution of cloudy insulant, correct use of skin folds and safe disposal of sharps.
Funding
BD Diabetes Care.</description><subject>Cardiology</subject><subject>Diabetes</subject><subject>Diabetics</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Endocrinology</subject><subject>Injections</subject><subject>Insulin</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Research</subject><subject>Questionnaires</subject><subject>Surveys</subject><issn>1869-6953</issn><issn>1869-6961</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9ktFu0zAUhiMEYtPYA3CDLHHDTYYdx07MBVLVDZg0iaIVcWk5zknjktqdnQz1CXktHNJ1GwKSSI58vv8_PtafJC8JPiMYF28DoRTjFJMyxTnP0-JJckxKLlIuOHl6-Gf0KDkNYY3jQ4UQhDxPjjIRmSxnx8nP5eC_m9CiSxuGzti4rkH3xlm0BN1aczMAuu6HevcOLdx26NTv2rxVXukevAm90QG5Bt0ZLSIBtg_oh-lbdG5UBT0E9K11e-9DK2VrdA69Mt1k0ILxD_ovxg5GR60KaBYCxK9G1Q5dD_4WdujLAGEErTIeXiTPGtUFON2vJ8nXDxfL-af06vPHy_nsKtWMsz4FjCvKeUUY46LQRdZQUldQ1rqCAmdZmeuGCoxVxfJSaVoIjQlhOWiqRdVgepK8n3y3Q7WBWsdJverk1puN8jvplJGPK9a0cuVuJcc8Z0UZDd7sDby7GSeQGxM0dJ2y4IYgM8xpQfOyHHu9_gNdu8HbOJ6kWPCcc0HY_6jolcVsYEzuqZXqQBrbuHg6PbaWM84Ip6KkI3X2Fyq-NWyMdhYaE_cfCcgk0N6F4KE53ATBcoypnGIqY0zlGFNZRM2rh1d4UNyFMgLZBIRYsivw9xP92_UXH6P09Q</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Dagdelen, Selcuk</creator><creator>Deyneli, Oguzhan</creator><creator>Olgun, Nermin</creator><creator>Siva, Zeynep Osar</creator><creator>Sargin, Mehmet</creator><creator>Hatun, Sükrü</creator><creator>Kulaksizoglu, Mustafa</creator><creator>Kaya, Ahmet</creator><creator>Gürlek, Cansu Aslan</creator><creator>Hirsch, Laurence J.</creator><creator>Strauss, Kenneth W.</creator><general>Springer Healthcare</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1031-0067</orcidid></search><sort><creationdate>20180801</creationdate><title>Turkish Insulin Injection Technique Study: Population Characteristics of Turkish Patients with Diabetes Who Inject Insulin and Details of Their Injection Practices as Assessed by Survey Questionnaire</title><author>Dagdelen, Selcuk ; Deyneli, Oguzhan ; Olgun, Nermin ; Siva, Zeynep Osar ; Sargin, Mehmet ; Hatun, Sükrü ; Kulaksizoglu, Mustafa ; Kaya, Ahmet ; Gürlek, Cansu Aslan ; Hirsch, Laurence J. ; Strauss, Kenneth W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c565t-e00b366b155697c72f31dbe8dcbe702284cf3900ab548ac379c01154ec3c9bf03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Cardiology</topic><topic>Diabetes</topic><topic>Diabetics</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Endocrinology</topic><topic>Injections</topic><topic>Insulin</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Research</topic><topic>Questionnaires</topic><topic>Surveys</topic><toplevel>online_resources</toplevel><creatorcontrib>Dagdelen, Selcuk</creatorcontrib><creatorcontrib>Deyneli, Oguzhan</creatorcontrib><creatorcontrib>Olgun, Nermin</creatorcontrib><creatorcontrib>Siva, Zeynep Osar</creatorcontrib><creatorcontrib>Sargin, Mehmet</creatorcontrib><creatorcontrib>Hatun, Sükrü</creatorcontrib><creatorcontrib>Kulaksizoglu, Mustafa</creatorcontrib><creatorcontrib>Kaya, Ahmet</creatorcontrib><creatorcontrib>Gürlek, Cansu Aslan</creatorcontrib><creatorcontrib>Hirsch, Laurence J.</creatorcontrib><creatorcontrib>Strauss, Kenneth W.</creatorcontrib><creatorcontrib>ITQ Turkish Study Group</creatorcontrib><creatorcontrib>the ITQ Turkish Study Group</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dagdelen, Selcuk</au><au>Deyneli, Oguzhan</au><au>Olgun, Nermin</au><au>Siva, Zeynep Osar</au><au>Sargin, Mehmet</au><au>Hatun, Sükrü</au><au>Kulaksizoglu, Mustafa</au><au>Kaya, Ahmet</au><au>Gürlek, Cansu Aslan</au><au>Hirsch, Laurence J.</au><au>Strauss, Kenneth W.</au><aucorp>ITQ Turkish Study Group</aucorp><aucorp>the ITQ Turkish Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Turkish Insulin Injection Technique Study: Population Characteristics of Turkish Patients with Diabetes Who Inject Insulin and Details of Their Injection Practices as Assessed by Survey Questionnaire</atitle><jtitle>Diabetes therapy</jtitle><stitle>Diabetes Ther</stitle><addtitle>Diabetes Ther</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>9</volume><issue>4</issue><spage>1629</spage><epage>1645</epage><pages>1629-1645</pages><issn>1869-6953</issn><eissn>1869-6961</eissn><abstract>Introduction
Over 7 million people in Turkey have diabetes. Of the 1 million who inject insulin little is known of their habits and injection techniques.
Methods
We conducted an Injection Technique Questionnaire (ITQ) survey throughout Turkey that involved 1376 patients from 56 centers. Turkish values were compared with those from 41 other countries participating in the ITQ, known here as Rest of World (ROW).
Results
The majority (50.4%) of Turkish insulin users give four injections/ day as opposed to ROW, where only 30.9% do. The abdomen is the most common injection site used by Turkish patients, but they also inject insulin in multiple body sites more often than do patients in ROW. Body mass index values in Turkey were 0.75 units higher than those in ROW as was the mean total daily dose (average daily dose [ADD]) of insulin (54.0 IU in Turkey vs. 47.4 IU in ROW). Mean glycated hemoglobin (HbA1c) in Turkey was 9.1%, which is higher than in ROW and possibly related to the higher BMI and ADD. Turkish patients use insulin analogs (short and long-acting) more frequently than do patients in ROW. The shortest pen needles (4 mm) are used by about one-third of patients in Turkey, but the longer ones (8 mm) are equally common. Needles are reused in Turkey at a rate of 3.4 injections/single needle. However, needle reuse, whether with pens or syringes, is lower in Turkey than ROW, as is the number of times a reused needle is used. More than 75% of used sharps in Turkey go into the rubbish, with nearly 6% having no protection of the tip.
Conclusion
The continued use of 8-mm needles raises the risk of intramuscular injections in Turkish patients. Despite full reimbursement, needle reuse still remains an important issue. More focus needs to be given to dwell times under the skin, reconstitution of cloudy insulant, correct use of skin folds and safe disposal of sharps.
Funding
BD Diabetes Care.</abstract><cop>Cheshire</cop><pub>Springer Healthcare</pub><pmid>29961245</pmid><doi>10.1007/s13300-018-0464-7</doi><tpages>17</tpages><orcidid>https://orcid.org/0000-0002-1031-0067</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1869-6953 |
| ispartof | Diabetes therapy, 2018-08, Vol.9 (4), p.1629-1645 |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Springer Nature OA Free Journals; PubMed Central |
| subjects | Cardiology Diabetes Diabetics Dosage and administration Drug therapy Endocrinology Injections Insulin Internal Medicine Medicine Medicine & Public Health Original Research Questionnaires Surveys |
| title | Turkish Insulin Injection Technique Study: Population Characteristics of Turkish Patients with Diabetes Who Inject Insulin and Details of Their Injection Practices as Assessed by Survey Questionnaire |
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