Identifying Methods Used to Avoid Insulin Injection Pain
Year 2024,
Volume: 13 Issue: 1, 25 - 32, 20.03.2024
Pınar Tunç Tuna
,
Enes Günhan
,
Halil İbrahim Tuna
,
Birsel Molu
,
Alev Yıldırım Keskin
Abstract
Objective: The aim of the study is to determine the knowledge levels of diabetes mellitus patients about the disease and insulin use and their practices to prevent insulin injection pain. Material and Methods: Data were collected from 399 patients who administered insulin injections in the study. Patient Identification Form, Disease and Treatment Compliance Form, Morisky-8 Treatment Adherence Scale (MMAS-8), and Visual Analog Scale were used for data collection. Results: According to the findings of the study, it was determined that 16.6% of the patients made correct rotation while administering insulin injection It was determined that 46.4% of the patients preferred the painless area while injecting. However, it was determined that patients who applied insulin injection correctly had higher pain scores. It has been determined that patients with complications related to DM have higher adherence to treatment. Conclusion: Although the vast majority of patients reported that they came to regular check-ups; it was found that they did not rotate correctly while injecting insulin, nearly half of the patients preferred to inject into the painless area as a way of avoiding pain, and patients who did not rotate experienced low pain associated with the injection. In addition, patients were found to have low adherence to treatment.
References
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- Aslan, I. & Korkmaz, M. (2015). Diabetes individuals insulin administration knowledge-skill content: Right and wrong. Dokuz Eylul University Faculty of Nursing Electronic Journal, 8 (1), 18-26.
- Aslan, E. O., Toygar, I., Feyizoğlu, G., Polat, S., & Aslan, F. E. (2023). Relationship between the insulin use and stigma in type 2 diabetes mellitus. Primary Care Diabetes. https://doi.org/10.1016/j.pcd.2023.05.002.
- Asılar, R. H., Gozum, S., Capık, C., & Morisky, D. E. (2014). Reliability and validity of the Turkish form of the eight-item Morisky medication adherence scale in hypertensive patients. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi, 14(8).
- Da Costa, A. K. G., de Azevedo Pereira, J. V. G., Júnior, S. S. F., de Oliveira Costa, R. R., & Amorim, É. G. (2023). Difficulties presented by patients with diabetes in self-administration of insulin: Scoping review, Rev Med Minas Gerais, 33(33203), 1-12. https://doi.org/10.5935/2238-3182.2023e33203.
- Danne, T., Phillip, M., Buckingham, B. A., Jarosz‐Chobot, P., Saboo, B., Urakami, T., Codner, E. (2018). ISPAD Clinical Practice Consensus Guidelines 2018: Insulin treatment in children and adolescents with diabetes. Pediatric diabetes, 19, 115-135. https://doi.org/10.1111/ pedi. 12718.
- Delgado, D. A., Lambert, B. S., Boutris, N., McCulloch, P. C., Robbins, A. B., Moreno, M. R., & Harris, J. D. (2018). Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews, 2(3). https://doi.org/10.5435/JAAOSGlobal-D-17-00088.
- EL-Mahdy, E. S. R., El-khedr, S. M., Elrifaey, S. M., & Elaraby, M. E. (2023). Effect of Shot Blockers versus Buzzy Bee Distractor on Relieving Pain and Anxiety Level during Insulin Injection among Children with Type I Diabetes. Tanta Scientific Nursing Journal, 29(2), 32-49.
- Famulla, S., Hövelmann, U., Fischer, A., Coester, H.-V., Hermanski, L., Kaltheuner, M., Hirsch, L. (2016). Insulin injection into lipohypertrophic tissue: blunted and more variable insulin absorption and action and impaired postprandial glucose control. Diabetes Care, 39(9), 1486-1492. https://doi.org/10.2337/dc16-0610.
- Fernandez-Lazaro, C. I., García-González, J. M., Adams, D. P., Fernandez-Lazaro, D., Mielgo-Ayuso, J., Caballero-Garcia, A., Miron-Canelo, J. A. (2019). Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study. BMC family practice, 20(1), 1-12. https://doi.org/10.1186/s12875-019-1019-3.
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- Gentile, S., Guarino, G., & Strollo, F. (2020). A cry of pain for painless insulin lipohypertrophy. Journal of Dia-betes Research Reviews & Reports. 2(1), 1-2.
- Gentile, S., Guarino, G., Corte, T. D., Marino, G., Fusco, A., Corigliano, G., Colarusso, S., & Strollo, F. (2020). Insulin-induced skin lipohypertrophy in type 2 diabetes: A multicenter regional survey in Southern Italy. Diabetes Therapy, 11(2001), 2001-2017. https://doi.org/10.1007/s13300-020-00876-0.
- Hernar, I., Haltbakk, J., & Broström, A. (2017). Differences in depression, treatment satisfaction and injection behaviour in adults with type 1 diabetes and different degrees of lipohypertrophy. Journal of Clinical Nursing, 26(23-24), 4583-4596. https://doi.org /1 0.1111/jocn.13801.
- Islam, S. M. S., Islam, M. T., Uddin, R., Tansi, T., Talukder, S., Sarker, F., Mamun, K. A. A., Adibi, S., & Rawal, L. B. (2021). Factors associated with low medication adherence in patients with Type 2 diabetes mellitus attending a tertiary hospital in Bangladesh. Lifestyle Medicine, 2(4), 1-8. https://doi.org/10.1002/lim2.47.
- Khan, M. K., & Baig, R. U. (2022). A Review on the management of gestational diabetes mellitus (GDM): pharmacological and non-pharmacological ınterventions. Journal of Clinical and Nursing Research, 6(4), 75-82. https://doi.org/10.26689/jcnr.v6i4.41 64.
- Kalra, S., Kumar, A., & Gupta, Y. (2016). Prevention of lipohypertrophy. JPMA. The Journal of the Pakistan Medical Association, 66(7), 910-911.
- Khunkaew, S., Fernandez, R., & Sim, J. (2019). Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis. Quality of Life Research, 28(6), 1413-1427. https://doi.org/ 10.1007/s11136-018-2082-2.
- Kim, H., Shah, K., & Buettner, C. (2022). Use of Patient-Reported Outcomes for Assessing Diabetes Outcomes. Endocrinology and Metabolism Clinics, 51(4), 781-793. https://doi.org/10.1016/j.ecl.2022.05 .001.
- Lee, G., Ma, Y., Lee, Y.-h., & Jung, H. (2018). Clinical evaluation of a low-pain long microneedle for subcutaneous insulin injection. BioChip Journal, 12(4), 309-316. https://doi.org/10.1007/s13206-018-2411-0.
- Morisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care, 67-74.
- Nagase, T., Iwaya, K., Iwaki, Y., Kotake, F., Uchida, R., Oh-i, T., & Katsura, Y. (2014). Insulin-derived amyloidosis and poor glycemic control: A case series. The American Journal of Medicine, 127(5), 450-454. https://doi.org/10 .1016/j.amjmed.2013.10.029.
- Pascal, I. G., Ofoedu, J. N., Uchenna, N. P., Nkwa, A. A., & Uchamma, G. U. E. (2012). Blood glucose control and medication adherence among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of eastern Nigeria. North American Journal of Medical Sciences, 4(7), 310. https://doi.org/10.4103/1947-2714.98590.
- PutrI, N. A. R., Harefa, D. Y., Sianturi, G. S., & Irawati, W. (2022). Potential use of insulin patch technology as transdermal drug delivery in efforts to treat diabetes mellitus. Biotropika: Journal of Tropical Biology, 10(3), 168-175. https://doi.org/10.21776/ub.biotropika.2022.010.03.02.
- Ramadan Esmail Magor, N., Youssef El-Sheikh, O., Farouk Mohamed, M., & Mohamed Ahmed Ayed, M. (2023). Effect of Foot Reflexology Massage on Pain and Anxiety Levels regarding Insulin Injection among Diabetic Children. Egyptian Journal of Health Care, 14(1), 1297-1312. https://doi.org/10.21608/EJHC.2023.300280.
- Spollett, G., Edelman, S. V., Mehner, P., Walter, C., & Penfornis, A. (2016). Improvement of insulin injection technique: examination of current issues and recommendations. The Diabetes Educator, 42(4), 379-394. https://doi.org/10.1177/014 5721716648017.
- Usach, I., Martinez, R., Festini, T., & Peris, J.-E. (2019). Subcutaneous injection of drugs: literature review of factors influencing pain sensation at the injection site. Advances In Therapy, 36(11), 2986-2996. https://doi.org/10.1007/s12325-019-01101-6.
- Usman, A., Yadav, R. R., Pagare, A., Ganguly, A., & Chakrabarti, R. (2023). Knowledge and awareness regarding diabetes and self-management among patients diagnosed with Type 2 diabetes mellitus–a preliminary surveillance study from a Tertiary Care Hospital. Apollo Medicine, 20(3), 181-191. https://doi.org/10.4103/am.am_176_22.
- Yoo, J. H., & Kim, J. H. (2023). Advances in continuous glucose monitoring and integrated devices for management of diabetes with insulin-based therapy: improvement in glycemic control. Diabetes & Metabolism Journal, 47(1), 27-41. https://doi.org/10. 4093/dmj.2022. 0271.
- Zhang, F.-Y., Shen, M., & Sun, L.-Q. (2022). Evaluation of clinical efficacy of continuous care with improved insulin injection techniques on patients with diabetes mellitus: a randomized controlled trial. Journal of International Medical Research, 50(6), 1-11. https://doi.org/10.1177/03000605221108047.
- Zijlstra, E., Jahnke, J., Fischer, A., Kapitza, C., & Forst, T. (2018). Impact of injection speed, volume, and site on pain sensation. Journal of Diabetes Science and Technology, 12(1), 163-168. https://doi.org/10.1177/1932296817735121.
İnsülin Enjeksiyonu Ağrısından Kaçınmak İçin Kullanılan Yöntemlerin Belirlenmesi
Year 2024,
Volume: 13 Issue: 1, 25 - 32, 20.03.2024
Pınar Tunç Tuna
,
Enes Günhan
,
Halil İbrahim Tuna
,
Birsel Molu
,
Alev Yıldırım Keskin
References
- Al-Haj Mohd, M. M., Phung, H., Sun, J., & Morisky, D. E. (2015). The predictors to medication adherence among adults with diabetes in the United Arab Emirates. Journal of Diabetes & Metabolic Disorders, 15(30), 1-9. https://doi.org/10.1186/s40200-016-0254-6
- Ansari, A. M., Osmani, L., Matsangos, A. E., & Li, Q. K. (2017). Current insight in the localized insulin-derived amyloidosis (LIDA): Clinico-pathological characteristics and differential diagnosis. Pathology-Research and Practice, 213(10), 1237-1241. https://doi.org/10.1016/j.prp.2017.08.013.
- Aslan, I. & Korkmaz, M. (2015). Diabetes individuals insulin administration knowledge-skill content: Right and wrong. Dokuz Eylul University Faculty of Nursing Electronic Journal, 8 (1), 18-26.
- Aslan, E. O., Toygar, I., Feyizoğlu, G., Polat, S., & Aslan, F. E. (2023). Relationship between the insulin use and stigma in type 2 diabetes mellitus. Primary Care Diabetes. https://doi.org/10.1016/j.pcd.2023.05.002.
- Asılar, R. H., Gozum, S., Capık, C., & Morisky, D. E. (2014). Reliability and validity of the Turkish form of the eight-item Morisky medication adherence scale in hypertensive patients. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi, 14(8).
- Da Costa, A. K. G., de Azevedo Pereira, J. V. G., Júnior, S. S. F., de Oliveira Costa, R. R., & Amorim, É. G. (2023). Difficulties presented by patients with diabetes in self-administration of insulin: Scoping review, Rev Med Minas Gerais, 33(33203), 1-12. https://doi.org/10.5935/2238-3182.2023e33203.
- Danne, T., Phillip, M., Buckingham, B. A., Jarosz‐Chobot, P., Saboo, B., Urakami, T., Codner, E. (2018). ISPAD Clinical Practice Consensus Guidelines 2018: Insulin treatment in children and adolescents with diabetes. Pediatric diabetes, 19, 115-135. https://doi.org/10.1111/ pedi. 12718.
- Delgado, D. A., Lambert, B. S., Boutris, N., McCulloch, P. C., Robbins, A. B., Moreno, M. R., & Harris, J. D. (2018). Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults. Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews, 2(3). https://doi.org/10.5435/JAAOSGlobal-D-17-00088.
- EL-Mahdy, E. S. R., El-khedr, S. M., Elrifaey, S. M., & Elaraby, M. E. (2023). Effect of Shot Blockers versus Buzzy Bee Distractor on Relieving Pain and Anxiety Level during Insulin Injection among Children with Type I Diabetes. Tanta Scientific Nursing Journal, 29(2), 32-49.
- Famulla, S., Hövelmann, U., Fischer, A., Coester, H.-V., Hermanski, L., Kaltheuner, M., Hirsch, L. (2016). Insulin injection into lipohypertrophic tissue: blunted and more variable insulin absorption and action and impaired postprandial glucose control. Diabetes Care, 39(9), 1486-1492. https://doi.org/10.2337/dc16-0610.
- Fernandez-Lazaro, C. I., García-González, J. M., Adams, D. P., Fernandez-Lazaro, D., Mielgo-Ayuso, J., Caballero-Garcia, A., Miron-Canelo, J. A. (2019). Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study. BMC family practice, 20(1), 1-12. https://doi.org/10.1186/s12875-019-1019-3.
- Frid, A. H., Hirsch, L. J., Menchior, A. R., Morel, D. R., & Strauss, K. W. (2016). Worldwide Injection Technique Questionnaire Study: Population Parameters and Injection Practices. Mayo Clinic Proceedings, 91(9), 1212-1223. https://doi.org/ 10.1016/j.mayocp.2016.06.011.
- Gentile, S., Guarino, G., & Strollo, F. (2020). A cry of pain for painless insulin lipohypertrophy. Journal of Dia-betes Research Reviews & Reports. 2(1), 1-2.
- Gentile, S., Guarino, G., Corte, T. D., Marino, G., Fusco, A., Corigliano, G., Colarusso, S., & Strollo, F. (2020). Insulin-induced skin lipohypertrophy in type 2 diabetes: A multicenter regional survey in Southern Italy. Diabetes Therapy, 11(2001), 2001-2017. https://doi.org/10.1007/s13300-020-00876-0.
- Hernar, I., Haltbakk, J., & Broström, A. (2017). Differences in depression, treatment satisfaction and injection behaviour in adults with type 1 diabetes and different degrees of lipohypertrophy. Journal of Clinical Nursing, 26(23-24), 4583-4596. https://doi.org /1 0.1111/jocn.13801.
- Islam, S. M. S., Islam, M. T., Uddin, R., Tansi, T., Talukder, S., Sarker, F., Mamun, K. A. A., Adibi, S., & Rawal, L. B. (2021). Factors associated with low medication adherence in patients with Type 2 diabetes mellitus attending a tertiary hospital in Bangladesh. Lifestyle Medicine, 2(4), 1-8. https://doi.org/10.1002/lim2.47.
- Khan, M. K., & Baig, R. U. (2022). A Review on the management of gestational diabetes mellitus (GDM): pharmacological and non-pharmacological ınterventions. Journal of Clinical and Nursing Research, 6(4), 75-82. https://doi.org/10.26689/jcnr.v6i4.41 64.
- Kalra, S., Kumar, A., & Gupta, Y. (2016). Prevention of lipohypertrophy. JPMA. The Journal of the Pakistan Medical Association, 66(7), 910-911.
- Khunkaew, S., Fernandez, R., & Sim, J. (2019). Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis. Quality of Life Research, 28(6), 1413-1427. https://doi.org/ 10.1007/s11136-018-2082-2.
- Kim, H., Shah, K., & Buettner, C. (2022). Use of Patient-Reported Outcomes for Assessing Diabetes Outcomes. Endocrinology and Metabolism Clinics, 51(4), 781-793. https://doi.org/10.1016/j.ecl.2022.05 .001.
- Lee, G., Ma, Y., Lee, Y.-h., & Jung, H. (2018). Clinical evaluation of a low-pain long microneedle for subcutaneous insulin injection. BioChip Journal, 12(4), 309-316. https://doi.org/10.1007/s13206-018-2411-0.
- Morisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care, 67-74.
- Nagase, T., Iwaya, K., Iwaki, Y., Kotake, F., Uchida, R., Oh-i, T., & Katsura, Y. (2014). Insulin-derived amyloidosis and poor glycemic control: A case series. The American Journal of Medicine, 127(5), 450-454. https://doi.org/10 .1016/j.amjmed.2013.10.029.
- Pascal, I. G., Ofoedu, J. N., Uchenna, N. P., Nkwa, A. A., & Uchamma, G. U. E. (2012). Blood glucose control and medication adherence among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of eastern Nigeria. North American Journal of Medical Sciences, 4(7), 310. https://doi.org/10.4103/1947-2714.98590.
- PutrI, N. A. R., Harefa, D. Y., Sianturi, G. S., & Irawati, W. (2022). Potential use of insulin patch technology as transdermal drug delivery in efforts to treat diabetes mellitus. Biotropika: Journal of Tropical Biology, 10(3), 168-175. https://doi.org/10.21776/ub.biotropika.2022.010.03.02.
- Ramadan Esmail Magor, N., Youssef El-Sheikh, O., Farouk Mohamed, M., & Mohamed Ahmed Ayed, M. (2023). Effect of Foot Reflexology Massage on Pain and Anxiety Levels regarding Insulin Injection among Diabetic Children. Egyptian Journal of Health Care, 14(1), 1297-1312. https://doi.org/10.21608/EJHC.2023.300280.
- Spollett, G., Edelman, S. V., Mehner, P., Walter, C., & Penfornis, A. (2016). Improvement of insulin injection technique: examination of current issues and recommendations. The Diabetes Educator, 42(4), 379-394. https://doi.org/10.1177/014 5721716648017.
- Usach, I., Martinez, R., Festini, T., & Peris, J.-E. (2019). Subcutaneous injection of drugs: literature review of factors influencing pain sensation at the injection site. Advances In Therapy, 36(11), 2986-2996. https://doi.org/10.1007/s12325-019-01101-6.
- Usman, A., Yadav, R. R., Pagare, A., Ganguly, A., & Chakrabarti, R. (2023). Knowledge and awareness regarding diabetes and self-management among patients diagnosed with Type 2 diabetes mellitus–a preliminary surveillance study from a Tertiary Care Hospital. Apollo Medicine, 20(3), 181-191. https://doi.org/10.4103/am.am_176_22.
- Yoo, J. H., & Kim, J. H. (2023). Advances in continuous glucose monitoring and integrated devices for management of diabetes with insulin-based therapy: improvement in glycemic control. Diabetes & Metabolism Journal, 47(1), 27-41. https://doi.org/10. 4093/dmj.2022. 0271.
- Zhang, F.-Y., Shen, M., & Sun, L.-Q. (2022). Evaluation of clinical efficacy of continuous care with improved insulin injection techniques on patients with diabetes mellitus: a randomized controlled trial. Journal of International Medical Research, 50(6), 1-11. https://doi.org/10.1177/03000605221108047.
- Zijlstra, E., Jahnke, J., Fischer, A., Kapitza, C., & Forst, T. (2018). Impact of injection speed, volume, and site on pain sensation. Journal of Diabetes Science and Technology, 12(1), 163-168. https://doi.org/10.1177/1932296817735121.