Faulty Injection Technique: A Preventable But Often Overlooked Factor in Insulin Allergy

Chakraborty, Partha Pratim; Biswas, Swarnendu; Patra, Shinjan

doi:10.1007/s13300-016-0151-5

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…Incorrect insulin injection techniques are not only associated with higher consumption of insulin and higher glycated hemoglobin values but also are responsible for higher frequencies of unexpected hypoglycemia and glucose variability [ 8 ]. Moreover, it has been also reported that faulty injection technique can cause insulin allergy [ 12 , 13 ]. Furthermore, there are evidences suggesting suboptimal disposal of needle after use [ 8 , 9 ], thereby increasing the risk of transmitting blood-borne infections [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Insulin Injection Practice among Diabetes Patients in a Tertiary Healthcare Centre in Nepal: A Preliminary Study

Poudel

Shrestha

Piryani

et al. 2017

Journal of Diabetes Research

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Introduction Proper insulin injection practice is essential for better diabetic control. This study aims to assess the insulin injection practice of patients with diabetes. Materials and Methods A cross-sectional study was conducted at Chitwan Medical College Teaching Hospital, Bharatpur, Nepal, from February 2017 to May 2017. Patients injecting insulin through insulin pens (n = 43) for a minimum of 4 weeks were consecutively recruited. Patients' baseline characteristics, current insulin injection technique, insulin transportation practice, complications of insulin injection, disposal practice of used needle, and acceptability of insulin were recorded. Descriptive statistics were performed using IBM-SPSS 20.0. Results The insulin injection technique of patients and their relatives was inadequate. The majority of patients and their relatives (25, 58.1%) mentioned that they transport their insulin cartridge without maintaining cold chain. Thirteen patients (30.2%, n = 43) reported complications of insulin injection and the most common complication among those patients was bruising (10, 76.9%, n = 13). Almost all patients disposed the used needle improperly, and the common method was disposing the needle in a dustbin and then transferring to municipal waste disposal vehicle. Insulin was accepted by just 16 (37.2%) patients. Conclusion There was a significant gap between the insulin delivery recommendation through insulin pen and current insulin injection practice.

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Section: Introductionmentioning

confidence: 99%

Assessment of Insulin Injection Practice among Diabetes Patients in a Tertiary Healthcare Centre in Nepal: A Preliminary Study

Poudel

Shrestha

Piryani

et al. 2017

Journal of Diabetes Research

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“…Although these insulin formulations had cresol, she was patch tested negative for cresol. Other insulin-allergy mimics reported are due to allergens in insulin infusion devices ( 20 ), allergy to natural latex rubber antigens in insulin injection material ( 21 ) and faulty injection technique ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Insulin Allergy to Detemir Followed by Rapid Onset of Diabetic Ketoacidosis: A Case Report and Literature Review

et al. 2022

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The management of diabetes mellitus in an insulin-dependent patient is challenging in the setting of concomitant antibody-mediated-insulin hypersensitivity. We report a case of a 62-year-old woman with pre-existing type 2 diabetes mellitus of 10 years duration who developed type 3 hypersensitivity reaction to insulin analogue detemir, and subsequently, severe diabetic ketoacidosis (DKA). She was C-peptide negative and was diagnosed with insulin-dependent diabetes. Despite increasing dose adjustments, insulin-meal matching, and compliance with insulin, she experienced episodes of unexpected hyperglycaemia and hypoglycaemia. The development of rash after detemir initiation and rapid progression to DKA suggests an aberrant immune response leading to the insulin allergy and antibody-induced interference with insulin analogues. Glycaemic control in the patient initially improved after being started on subcutaneous insulin infusion pump with reduced insulin requirements. However, after a year on pump therapy, localised insulin hypersensitivity reactions started, and glycaemic control gradually deteriorated.

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“…Correct insulin delivery is critical for better diabetes control [ 5 ]. Faulty injection technique not only results in inadequate glycemic control [ 6 ] but also results in hypoglycemia [ 7 ] and insulin allergy [ 8 , 9 ]. In this study, we report a case of poor glycemic control as a consequence of inappropriate insulin injection technique.…”

Section: Introductionmentioning

confidence: 99%

Diabetes Mellitus with Poor Glycemic Control as a Consequence of Inappropriate Injection Technique

Poudel

Shrestha

Bhandari

et al. 2018

Case Reports in Endocrinology

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Majority of patients with diabetes mellitus (DM), who are on insulin therapy, use insulin pen for convenience, accuracy, and comfort. Some patients may require two different types of insulin preparations for better glycemic control. We have reported a case of poor glycemic control as a consequence of inappropriate insulin injection technique. A 57-year-old man with type 2 DM had been using premix insulin 30 : 70 for his glycemic control for the last 12 years. On follow-up visit, his blood sugar level (BSL) had increased; therefore the treating physician increased the dose of premix insulin and added basal insulin with the aim of controlling his blood sugar level. Despite these changes, his BSL was significantly higher than his previous level. On investigation, the cause of his poor glycemic control was found to be due to inadequate delivery of insulin (primarily premix) as a consequence of lack of priming and incompatibility of single insulin pen for two cartridges. His basal insulin was discontinued and the patient along with his grandson was instructed to administer insulin correctly. After correction of the errors, the patient had a better glycemic control.

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Faulty Injection Technique: A Preventable But Often Overlooked Factor in Insulin Allergy

Cited by 8 publications

References 7 publications

Assessment of Insulin Injection Practice among Diabetes Patients in a Tertiary Healthcare Centre in Nepal: A Preliminary Study

Assessment of Insulin Injection Practice among Diabetes Patients in a Tertiary Healthcare Centre in Nepal: A Preliminary Study

Insulin Allergy to Detemir Followed by Rapid Onset of Diabetic Ketoacidosis: A Case Report and Literature Review

Diabetes Mellitus with Poor Glycemic Control as a Consequence of Inappropriate Injection Technique

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