EADSG Guidelines: Insulin Storage and Optimisation of Injection Technique in Diabetes Management

dc.contributor.authorBahendeka, Silver
dc.contributor.authorKaushik, Ramaiya
dc.contributor.authorBabu Swai, Andrew
dc.contributor.authorOtieno, Fredrick
dc.contributor.authorBajaj, Sarita
dc.contributor.authorKalra, Sanjay
dc.contributor.authorBavuma, Charlotte M
dc.contributor.authorKarigire, Claudine
dc.date.accessioned2023-02-14T13:53:18Z
dc.date.available2023-02-14T13:53:18Z
dc.date.issued2019-02-27
dc.description.abstractTo date, insulin therapy remains the cornerstone of diabetes management; but the art of injecting insulin is still poorly understood in many health facilities. To address this gap, the Forum for Injection Technique and Therapy Expert Recommendations (FITTER) published recommendations on injection technique after a workshop held in Rome, Italy in 2015. These recommendations are generally applicable to the majority of patients on insulin therapy, athough they do not explore alternative details that may be suitable for low- and middle-income countries. The East Africa Diabetes Study Group sought to address this gap, and furthermore to seek consensus on some of the contextual issues pertaining to insulin therapy within the East African region, specifically focusing on scarcity of resources and its adverse effect on the quality of care. A meeting of health care professionals, experts in diabetes management and patients using insulin, wasconvened in Kigali, Rwanda on 11 March 2018, and the following recommendations were made: (1) insulin should be transported safely, without undue shaking and exposure to high ([32 C) temperature environments. (2) Insulin should not be transported below 0 C. (3) If insulin is to be stored at home for over 2 months, it should be stored at the recommended temperature of 2–8 C. (4) Appropriate instructions should be given to patients while dispensing insulin. (5) Insulin in use should be kept at room temperature and should never be kept immersed under water. Immersing insulin under water after the vial has been pierced carries a high risk of contamination, leading to loss of potency and likelihood of causing injection abscesses. (6) The shortest available needles (4 mm for pen and 6 mm for insulin syringe) should be preferred for all patients. (7) In routine care, intramuscular injections should be avoided, especially with long-acting insulins, as it may result in severe hypoglycaemia. (8) The practice of slanting the needle excessively should be avoided as it results in sub-epidermal injection of insulin which leads to poor absorption and may cause ‘‘tattooing’’ of the skin and scarring. (9) In patients presenting in a wasted state, with ‘‘paperlike skin’’, injections should, if possible, be initiated with pen injection devices, so as to utilise the 4-mm needle without lifting a skin fold (pinching the skin); otherwise lifting of a skin fold is required, if longer needles are utilised. (10) Reuse of needles and syringes is not recommended. However, as the reuse of syringes and needles is practiced for various reasons, and by many patients, individuals should not be given alarming messages; and usage should be limited to discarding when injections become more painful; but at any rate not to exceed reusing a needle more than 5 times.en_US
dc.identifier.citationBahendeka, S., Kaushik, R., Swai, A.B., Otieno, F., Bajaj, S., Kalra, S., Bavuma, C.M. and Karigire, C., 2019. EADSG guidelines: insulin storage and optimisation of injection technique in diabetes management. Diabetes Therapy, 10, pp.341-366.en_US
dc.identifier.urihttp://hdl.handle.net/20.500.12280/3011
dc.publisherPMCen_US
dc.subjectCold chainen_US
dc.subjectDiabetesen_US
dc.subjectInjectionen_US
dc.subjectInsulinen_US
dc.subjectLow incomeen_US
dc.titleEADSG Guidelines: Insulin Storage and Optimisation of Injection Technique in Diabetes Managementen_US
dc.typeArticleen_US

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
s Bahendeka 1.pdf
Size:
1.46 MB
Format:
Adobe Portable Document Format
Description:

License bundle

Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description: