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Diabetes Therapy
Published in: Diabetes Therapy 3/2017

Open Access 01-06-2017 | Original Research

Indian Injection Technique Study: Population Characteristics and Injection Practices

Authors: Sanjay Kalra, Ambrish Mithal, Rakesh Sahay, Mathew John, A. G. Unnikrishnan, Banshi Saboo, Sujoy Ghosh, Debmalya Sanyal, Laurence J. Hirsch, Vandita Gupta, Kenneth W. Strauss

Published in: Diabetes Therapy | Issue 3/2017

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Abstract

Introduction

It was estimated that 3.2 million Indians with diabetes injected insulin in 2010, but little is known about the techniques used.

Methods

In 2015 we conducted an injection technique questionnaire (ITQ) survey throughout India involving 1011 patients. Indian values were compared with those from 41 other countries participating in the ITQ, known here as rest of world (ROW).

Results

Mean HbA1c was 8.6. BMI values in India were 1.5–3 units lower than in ROW depending on patient group, meaning the risk of intramuscular (IM) injections is high in India. The mean total daily dose (TDD) of insulin was lower in every category of Indian patient than in ROW, perhaps reflecting the lower BMI. Needle reuse, whether with pens or syringes, is much higher in India than ROW and so is the number of times the needle is used. The majority (56.8%) of Indian insulin users performed only 2 injections/day as opposed to ROW where 45% of patients performed at least 4 injections/day. Indian patients inject insulin in the thighs more often than patients in ROW, a site where IM injections are more risky. Many patients do not have proper access to sharps containers or have other risk factors that could lead to blood-borne pathogen spread. More than 60% of used sharps in India go into the rubbish, with nearly 12% not even having the minimum protection of a cap.

Discussion

The shortest needles are very common in India; however, the level of needle reuse is high. Multiple daily injections therapy is not as common in India as ROW. More focus needs to be given to dwell times under the skin, reconstitution of cloudy insulins, skinfolds, and safe sharps disposal.
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Metadata
Title
Indian Injection Technique Study: Population Characteristics and Injection Practices
Authors
Sanjay Kalra
Ambrish Mithal
Rakesh Sahay
Mathew John
A. G. Unnikrishnan
Banshi Saboo
Sujoy Ghosh
Debmalya Sanyal
Laurence J. Hirsch
Vandita Gupta
Kenneth W. Strauss
Publication date
01-06-2017
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 3/2017
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-017-0243-x

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