Problems Associated with Insulin Administration Among Patients with Type 2 Diabetes Mellitus

Prevalence of diabetes is on the rise globally. Disparity in the availability and affordability of diabetes care, as well as low awareness of the disease and a lack of good glycemic control increases the burden of the disease. Insulin therapy is the corner stone of treatment of type 2 diabetes and goes a long way in achieving glycemic control. However, several issues have been identified with insulin administration. This study aims to identify the problems of patients on insulin injection. A cross sectional survey was done on 300 type 2 diabetes mellitus patients on problems associated with insulin administration in a tertiary care hospital in Kerala, South India. Objectives were to identify the problems of patients on insulin administration and to correlate the duration of insulin administration with the problems. Among the physical problems reported, 31 % of subjects had tenderness, 22.3 % of subjects had colour change at the insulin injection site, 19 % of subjects had fatigue and 7.3 % of subjects had itching at the insulin injection site. Majority of subjects (95.7 %) had mild physical problems related to insulin injection and 4.3 % had moderate physical problems ( mean 16.5 SD 5.3) Among psychosocial problems, it was noted that 62 % of them avoided carrying insulin during travel, where as 40.7 % of subjects never used to skip long trips due to difficulty in taking insulin injections while travelling. Family members were supportive about insulin administration in 85.3 % of subjects. Majority (45.3 %) of subjects did not feel that they were a financial burden for the family. Majority (61.6 %) were not worried about repeated insulin injections and possible complications if insulin injection is skipped. Only 43 % were worried about low blood sugar levels while they are on insulin. Majority (62 %) of patients had moderate level of psychosocial and financial problems associated with insulin administration, where as 34.3 % had mild problems and 3.7 % had severe problems (mean 16.5 SD 5.3). The study revealed that there is a significant correlation between duration of insulin administration and problems associated with insulin administration (pless than 0.01)