Short needles (8 mm) reduce the risk of intramuscular injections in children with type 1 diabetes.

Tubiana‐Rufi, N.; Belarbi, Nadia; Pasquier-Fediaevsky, L Du; Polak, M.; Kakou, Bénédicte; Leridon, Laurence; Hassan, Mohd Rohaizat; Czernichow, P

doi:10.2337/diacare.22.10.1621

Cited by 67 publications

(60 citation statements)

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“…Sabe-se que no esforço de encorajar os pacientes a adotarem esquemas de múltiplas injeções diárias de insulina para melhorar o controle glicêmico, com mais conforto na aplicação de insulina, os fabricantes produziram agulhas mais finas e mais curtas entre 5mm e 15mm das observadas no mercado. A preocupação com o tamanho e material da agulha surge pelas injúrias e principalmente, pelas injeções intramusculares com agulhas maiores, levando à absorção mais rápida e a hipoglicemia (39) .…”

Section: Discussionunclassified

Reutilização de seringas descartáveis no domicílio de crianças e adolescentes com diabetes mellitus

Castro

Grossi

2007

Rev. esc. enferm. USP

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O fornecimento inadequado ou insuficiente de medicações e materiais para aplicar insulina, leva às famílias a adotarem estratégias variadas, como a prática de reutilização de seringas na tentativa de minimizar os custos com a doença. Objetivos: avaliar a prática de preparo e aplicação de insulina, evidenciar alterações freqüentes nos locais de aplicação de insulina. Este estudo foi comparativo, transversal, com 199 crianças e adolescentes diabéticos do Ambulatório do Instituto da Criança de São Paulo. Dividiu-se em Grupo A que reutiliza seringas descartáveis e Grupo B não as reutiliza. Estratégia comum foi o reencape da agulha sem limpeza prévia, guarda dentro ou fora da geladeira em recipiente fechado. Maior queixa foi a dor. O Hospital e o enfermeiro foram os responsáveis pela orientação dessa prática.

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Section: Discussionunclassified

Reutilização de seringas descartáveis no domicílio de crianças e adolescentes com diabetes mellitus

Castro

Grossi

2007

Rev. esc. enferm. USP

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“…Among the stages of the insulin administration procedures, we highlight the knowledge of the syringe and needle as indispensable tools for the procedure, with predominance of plastic disposable syringe graduated in 100 IU, because of its lower cost, ease of acquisition and material handling (9) . However, in large part the evaluation of IC, participants did not known the size of the needle for administering insulin, which is an indispensable information due to the risk associated with injuries, such as: intramuscular administration with larger needles, leading to faster absorption and hypoglycemia (25) . It is worth mentioning the knowledge about differences in grading scales between insulin syringes 30IU, 50IU and 100 IU, whereas in a recent study 24.9% of the participants with DM cited difficulties in visualizing the dosage of insulin in the syringe, 10.6% reported motor difficulties during aspiration technique and 36.1% aspirated different dosage from the prescribed (13) .…”

Section: Discussionmentioning

confidence: 99%

Nursing intervention in insulin administration: telephone follow-up

Becker¹,

Teixeira

Zanetti

2012

Acta paul. enferm.

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Objective: To analyze the competency of people with diabetes mellitus to perform the insulin administration process, before and after telephone monitoring. Methods: A quantitative, observational, longitudinal, comparative study. Participants were 26 people enrolled in the at-home capillary glycemia self-monitoring program. Data collection occurred in three phases, in January and February of 2010, for a period of 30 days for each person, by means of interview guided by a data collection instrument and an intervention manual. Results: Of the 38 (100%) questions referring to the insulin administration process, telephone monitoring was demonstrated to be efficient in 30 (78.9%), but in 19 (50%) the intervention was statistically significant (p<0.05), in 11 (28.9%) there were no errors in responses to the final competency evaluation, and seven (18.4%) were not amenable to intervention. Conclusion: Telephone mornitoring was effective, as a nursing intervention strategy for the insulin administration process in the home. Keywords: Insulin; Diabetes mellitus; Nursing Care; Telephone ReSumoObjetivo: Analisar a competência da pessoa com Diabetes mellitus para realizar o processo de aplicação de insulina, antes e após o acompanhamento por telefone. Métodos: Estudo de abordagem quantitativa, observacional, longitudinal, comparativo. Participaram 26 pessoas cadastradas no programa de automonitorização da glicemia capilar no domicílio. A coleta de dados ocorreu em três fases, entre janeiro e fevereiro de 2010, no período de 30 dias para cada pessoa, por meio de entrevista, norteada pelo instrumento de coleta de dados e o manual de intervenção. Resultados: Das 38 (100%) questões referentes ao processo de aplicação de insulina, o acompanhamento por telefone demonstrou-se eficiente em 30 (78,9%), pois em 19(50%) a intervenção foi estatisticamente significante (p<0,05), em 11(28,9%) não houve erros nas respostas na avaliação da competência final e sete (18,4%) não eram passíveis de intervenção. Conclusão: O acompanhamento por telefone foi efetivo, como estratégia de intervenção de enfermagem no processo de aplicação de insulina no domicílio. Descritores: Insulina/uso terapêutico; Diabetes mellitus/enfermagem; Cuidados de enfermagem; Telefone ReSumeNObjetivo: Analizar la competencia de la persona con Diabetes mellitus para realizar el proceso de aplicación de insulina, antes y después de acompañamiento por teléfono. Métodos: Se trata de un estudio de abordaje cuantitativo, observacional, longitudinal, comparativo. Participaram 26 personas registradas en el programa de automonitorización de la glicemia capilar en el domicilio. La recolección de los datos se llevó a cabo em tres fases, entre enero y febrero del 2010, en el período de 30 días para cada persona, por medio de entrevista, orientada por el instrumento de recolección de datos y el manual de intervención. Resultados: De las 38 (100%) preguntas referentes al proceso de aplicación de insulina, el acompañamiento por teléfono demostró que es eficiente en 30 (78,9%), pu...

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“…This is possible with short (4 mm) needles, which reduce the risk of intramuscular injection and do not increase insulin backflow even when inserted at 90°w ithout pinching the skin [17][18][19][20][21][22][23]. The use of a 4 mm needle is suitable for adults, irrespective of BMI [10], as well as for children and adolescents [18,19,24] but the pinch technique may still be required in very thin subjects [23]. In the transition from a longer needle to a shorter one, there might be differences in insulin absorption, therefore monitoring blood Subcutaneous tissue thickness varies significantly depending on sex, body mass index, age, ethnicity, diabetes type, morphology of the diabetic individual, as well as, on pressure exerted during injection [8,11,14].…”

Section: Commentsmentioning

confidence: 99%

“…As accidental intramuscular shots might cause hypoglycaemia [16][17][18][19][20], it is necessary to inject insulin beyond 2.5 mm without getting into the muscle. This is possible with short (4 mm) needles, which reduce the risk of intramuscular injection and do not increase insulin backflow even when inserted at 90°w ithout pinching the skin [17][18][19][20][21][22][23]. The use of a 4 mm needle is suitable for adults, irrespective of BMI [10], as well as for children and adolescents [18,19,24] but the pinch technique may still be required in very thin subjects [23].…”

Section: Commentsmentioning

confidence: 99%

AMD-OSDI Consensus on Injection Techniques for People with Diabetes Mellitus

Gentile¹,

Grassi²,

Armentano³

et al. 2016

Med Clin Rev

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It goes without saying that all people with diabetes should be taught the best injection technique before starting insulin treatment. Nevertheless the extremely high rate of local injection-related skin reactions-i.e., lipodysthrophic lesions-described in literature, proves otherwise.We are hereby presenting a Consensus Document on Injecting Techniques which highlights 18 key points based on a thorough analysis of the available literature and ranked by "Level of evidence" and "Strength of recommendation" according to our National Guideline System.It is meant at providing all professionals involved in diabetes care with a practical guide on how to help patients on insulin perform well. Keywords: Insulin injections; Diabetes mellitus;Recommendations; Lipohypertrophy Was a Consensus Document on Injecting Techniques really needed?According to data from ISTAT (National Institute of Statistic) 2011 report [1] about 3 million people with diabetes mellitus (DM) are living in Italy nowadays, mostly in the South of our country, with a 5.1% prevalence of type 1 DM (T1DM). ARNO 2011 report, on the other side, witnessed in favour of a 10-year lasting ever increasing utilization of newer insulin preparations endowed with a more physiological pharmacokinetics profile, such as rapid-acting and basal analogues, as well as, of innovative therapeutic regimes [2]. In spite of technological progresses, and a general improvement in the quality of care, the 2012 AMD Annals [3] reported that only 22.2% T1DM and 43.8% T2DM patients reached HbA1c levels below 7% (53 mmol/mol), and T2DM patients above 9% (75 mmol/mol) accounted for 25.7% monitored people.Many factors related to insulin administration, storage and handling might contribute to poor metabolic control. Therefore, a major goal of health care teams is to educate patients and caregivers to the best possible injectable drug administration techniques and the most skilful utilization of related available devices.In order to let them reach that goal, we collected all available scientific evidences on this issue and organised it according to well-defined hierarchically distributed criteria targeted at patient's self-management/empowerment [4], and based on National Guideline System [5] with structured education on top. Our Consensus Document on Injecting Techniques represents in fact the final result of this strong clinical effort. Recommendations concerning injectable drug administrationA correct injection technique is essential for insulin and other subcutaneously administered medications to ensure optimal effects in people with diabetes mellitus (DM). It implies the ability to (i) choose the best needles, (ii) rotate injection sites regularly, (iii) handle and store insulin appropriately, (iv) insert needles correctly into the skin, (v) let pen needles inside the skin long enough to get the whole dose be absorbed and (vi) manipulate the skin before and after injection (Table 1) Insulin must be injected into intact subcutaneous tissue and intramuscular shots have to be av...

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Short needles (8 mm) reduce the risk of intramuscular injections in children with type 1 diabetes.

Abstract: Needles that are 8 mm long significantly reduce the risk of intramuscular insulin injection in slim or normal-weight (BMI < or = 60th percentile) diabetic children and adolescents.

Cited by 67 publications

References 0 publications

Reutilização de seringas descartáveis no domicílio de crianças e adolescentes com diabetes mellitus

Reutilização de seringas descartáveis no domicílio de crianças e adolescentes com diabetes mellitus

Nursing intervention in insulin administration: telephone follow-up

AMD-OSDI Consensus on Injection Techniques for People with Diabetes Mellitus

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