Impact of patient satisfaction with insulin pens on glycemic control

Year 2022, Volume: 5 Issue: 3, 901 - 906, 30.05.2022

Işılay Kalan Sarı , Hüseyin Demirci

https://doi.org/10.32322/jhsm.1076784

Abstract

Aim: Adherence to the insulin regimen is poor. The use of an insulin pen contributes positively to glycemic control by increasing patient satisfaction and adherence. The aim of this study is to analyze the influence of patients' opinions of insulin pen use on glycemic control in type 2 diabetes mellitus (T2DM).
Material and Method: 126 patients with T2DM who use insulin and inject it with insulin pens were included in the study. Patients' evaluations about the pens (ergonomics, ease of reading the dosage scale, dose selection, needle change, and ease of use of the insulin pen in general) were assessed. Glycemic parameters, demographic characteristics, and treatment protocol were recorded.
Results: Patients who perceived the use of the insulin pen as ergonomically 'excellent’ had a significantly lower HbA1c (8.0±1.4%) (p=0.04). HbA1c was significantly lower in patients who perceived needle tip replacement as ‘very easy’ (8.0±1.6%) (p=0.04). No statistically significant relationship was found between the ease of reading the dosage scale and the HbA1c value (p=0.53). The HbA1c value decreased significantly in patients who rated the dosage selection as 'very easy' (8.1±1.7%) (p=0.02). The HbA1c value increased significantly in patients who rated the pen as ‘difficult’ to use (12.2±1.6%) (p=0.01).
Conclusion: In our study, we found that patients' opinions of insulin pen use may influence glycemic control parameters. HbA1c was better in patients who found the insulin pen as easy to use and good in ergonomics. In T2DM, patient assessment of insulin pen injection is related to glycemic control. New studies are needed to say whether this situation is related to the appropriate dose of insulin injection or adherence to therapy.

Keywords

diabetes mellitus, insulin, injection, patient satisfaction, HbA1c

Project Number

yok

References

• Satman I, Omer B, Tutuncu Y, et al. TURDEP-II Study Group. Twelve year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013; 28: 169-80.
• Nathan DM, Buse JB, Davidson MB, et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2009; 32: 193-203.
• Al Mansari A, Obeid Y, Islam N, et al. GOAL study: clinical and non-clinical predictive factors for achieving glycemic control in people with type 2 diabetes in real clinical practice. BMJ Open Diabetes Res Care 2018; 6: e000519.
• Garcia-Perez LE, Álvarez M, Dilla T, Gil-Guillén V, Orozco-Beltrán D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther 2013; 4: 175-94.
• Donnelly LA, Morris AD, Evans JM. DARTS/MEMO collaboration. Adherence to insulin and its association with glycaemic control in patients with type 2 diabetes. QJM 2007; 100: 345-50.
• Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care 2004; 27: 1218-24.
• Farsaei S, Radfar M, Heydari Z, Abbasi F, Qorbani M. Insulin adherence in patients with diabetes: risk factors for injection omission. Prim Care Diabetes 2014; 8: 338-45.
• Sarbacker GB, Urteaga EM. Adherence to insulin therapy. Diabetes Spectr 2016; 29: 166-70.
• Gorska-Ciebiada M, Masierek M, Ciebiada M. Improved insulin injection technique, treatment satisfaction and glycemic control: Results from a large cohort education study. J Clin Transl Endocrinol 2020; 19: 100217.
• Meece J. Effect of insulin pen devices on the management of diabetes mellitus. Am J Health Syst Pharm 2008; 65: 1076-82.
• Clarke A, Spollett G. Dose accuracy and injection force dynamics of a novel disposable insulin pen. Expert Opin Drug Deliv 2007: 4: 165–74.
• Gorska-Ciebiada M, Masierek M, Ciebiada M. Improved insulin injection technique, treatment satisfaction and glycemic control: Results from a large cohort education study. J Clin Transl Endocrinol 2020; 19: 100217.
• Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 1990; 13: 227-36.
• Veasey R, Ruf CA, Bogatirsky D, et al. A review of reusable insulin pens and features of TouStar-a new reusable pen with a dedicated cartridge. Diabetol Metab Syndr 2021; 13: 147.
• Asakura T, Jensen KH. Comparison of intuitiveness, ease of use, and preference in two insulin pens. J Diabetes Sci Technol 2009; 3: 312-9.
• Reimer T, Hohberg C, Pfützner AH, Jørgensen C, Jensen KH, Pfützner A. Intuitiveness, instruction time, and patient acceptance of a prefilled insulin delivery device and a reusable insulin delivery device in a randomized, open-label, crossover handling study in patients with type 2 diabetes. Clin Ther 2008; 30: 2252-62.
• Warren ML, Brod M, Håkan-Bloch J, Sparre T, Chaykin LB. Patient-reported outcomes from a randomized, crossover trial comparing a pen injector with insulin degludec versus a pen injector with insulin glargine U100 in patients with type 2 diabetes. Curr Med Res Opin 2019; 35: 1623-29.
• Yakushiji F, Fujita H, Terayama Y, et al. The best insulin injection pen device for caregivers: results of injection trials using five insulin injection devices. Diabetes Technol Ther 2010; 12: 143-8.
• Nicolucci A, Cucinotta D, Squatrito S, et al. Clinical and socio-economic correlates of quality of life and treatment satisfaction in patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2009; 19: 45-53.
• Redekop WK, Koopmanschap MA, Stolk RP, Rutten GE, Wolffenbuttel BH, Niessen LW. Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care 2002; 25: 458-63.
• Misnikova IV, Dreval AV, Gubkina VA, Rusanova EV. The risks of repeated use of insulin pen needles in patients with diabetes mellitus. Diabetology 2011; 2: 2.
• Strauss K, De Gols H, Hannet I, Partanen TM, Frid A. A pan-European epidemiologic study of insulin injection technique in patients with diabetes. Pract Diab Int 2002; 19: 71-6.