Asian Journal of Research and Reports in Endocrinology

Knowledge, Practice, and Complications of Insulin-Self Injection among a Representative Sample of Diabetic Patients in Southern Tunisia

Yosra Mejdoub

Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Nouha Ketata *

Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Dhoha Ben Salah

Endocrinology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia. c High Institute of Nursing, University of Sfax, Tunisia.

Samira Jerbi

High Institute of Nursing, University of Sfax, Tunisia.

Hana Charfi

Endocrinology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Feten Hadj Kacem

Endocrinology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Sourour Yaich

Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Jamel Damak

Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Jihen Jdidi

Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Fatma Mnif

Endocrinology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Nabila Rekik

Endocrinology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Mouna Elleuch

Endocrinology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Mohamed Abid

Endocrinology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.

*Author to whom correspondence should be addressed.

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Abstract

Objective: Our study aimed to assess knowledge and practice of Tunisian diabetic patients regarding insulin-self-injecting and to determine insulin-injection complication as well as their independent factors.

Methods: It was a cross sectional study using investigator-administered-questionnaires among insulin self-injecting patients with DM attending Tunisian Endocrinology department on April 2021. Information regarding knowledge and practices relating to injection Technik and its complications were assessed by the insulin Injection-Technique-Questionnaire (ITQ).

Results: A total of 96 diabetic patients were included in the study. The median age was45 years with IQR=[36-60] years. There were 53(55.2%) subjects with diabetes type 1. Median insulin seniority was 10 years; IQR=[5-20] years. Prevalence of insulin-induced lipodystrophy among patients examined by healthcare worker was 55%. Independent factors of detected lipodystrophy were HBA1C level>10% (AOR=22), family history of diabetes (AOR=0.02), using warmed insulin (AOR=0.08), skin disinfection (AOR=0.005) and skin fold before injection (AOR=0.04). Prevalence of bleeding after injections was 87.5% (n=84). Its independent factors were skipping injections (AOR=27.6), HBA1C level>10% (AOR=10.6), seniority of diabetes>10 years (AOR=41.2) and history of chronic disease (AOR=15.4). Prevalence of pain while injecting was 54.2%. Independent factors of injection pain were having surgical history (AOR=20.2), dyslipidaemia (AOR=19), urban area (AOR=0.021), family history of diabetes (AOR=0.075) and insulin seniority>12 years (AOR=0.086). Leakage or backflow of insulin from skin was reported by 44 patients (45.8%). Its independent factors were dyslipidaemia (AOR=10.7), unmarried patients (AOR=4.7) and obese patients (AOR=0.1).

Conclusion: A poor level of knowledge as well as frequent insulin-injection-complications were observed. Thus, healthcare-providers should pay more attention to therapeutic education on insulin treatment.

Keywords: Complications, diabetes mellitus, insulin, knowledge

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