RSSDI endorses FIT recommendations for effective insulin management in diabetics

The initiative is expected to benefit over 2 million diabetes patients with regards to long time insulin and insulin-like therapy adherence, smooth drug delivery and minimisation of adverse side effects.

 

In the past, several studies have cited reasons as to why some patients dread insulin injection usage. 

 

According to a study published in Diabet Med, 20% of insulin users often or sometimes skipped their injections while 10% restricted their number of daily injections due to needle anxiety, pain or embarrassment. Another study has found that bacterial contamination, local inflammatory changes and injection pain increased in direct proportion to needle re-use, highlighting an increased risk of infection.

 

Prof S V Madhu, Professor & Head, Dept. of Medicine & Endocrinology, UCMS-GTB Hospital & President, Research Society for Study of Diabetes in India (RSSDI) said, “The number of people with Type 2 diabetes is on the rise in every country, with earlier diagnosis and longer life spans meaning that there is an increasing likelihood that they will need to use injectable therapies to control their condition. Therefore it becomes extremely important that standard insulin techniques and best practices are adopted across the country at par with global standards.”

 

FIT India is an autonomous organisation which supports people with diabetes using injectable therapies to achieve the best possible health outcomes that can be influenced by correct injection technique. The development of FIT and the subsequent India recommendations for injection technique have been supported by prominent medical technology firm Becton, Dickinson & Co. (BD India). 

 

Dr Rajeev Chawla, Sr. Consultant Diabetologist and Secy, Research Society for Study of Diabetes in India (RSSDI) said, “Poor technique, including the use of an inappropriate needle length, failure to rotate injection sites and the re-use of needles, can lead to insulin being absorbed in an unpredictable manner, potentially leading to complications such as hypoglycaemia, hyperglycaemia and even ketoacidosis in patients with Type 1 diabetes. Injection technique addresses all these factors, and more.”

 

As per the FIT recommendations, special emphasis is to be given to counter complications arising out of incorrect usage of injections and usage in special groups like elderly population, pregnant women and people with weak immunity. The recommendations also suggest correct injection technique that can help protect against lipohypertrophy (lump formation), unexplained hypoglycemia (low blood sugar) and blood glucose variation.

 

Estimate suggests out of 67 million diabetes patients living in India, 3 million use injections. Doctors feel that the rate of insulinization is low in India. This is a road block in the optimal management of diabetes because of fear of needles and lifelong dependence on insulin. It is estimated that two thirds (64%) of insulin users develop lipohypertrophy at some time in their lives that can result in varied absorption and consequent erratic glycaemic control.

 

Dr. Laurence Hirsch, Vice President, Global Medical Affairs, Diabetes Care at BD, said, “For patients, the understanding and practice of correct injection technique has the potential to make a real difference to their lives, helping to deliver their insulin more consistently, reduce discomfort and minimise the risk of developing associated complications such as lipohypertrophy. The key is education and our mission is to reach the influencers, educators and healthcare workers who will support and disseminate the new recommendations in their daily practice.”

 

Research has shown that that correct injection and infusion technique can have positive impact on the health outcomes of people living with diabetes. As per a study published in Journal of Clinical and Translational Endocrinology (2014), correct injection technique education not only improved blood glucose control in people with diabetes, but also provided greater satisfaction with therapy and lowered the daily consumption of insulin after only three months - a relatively short period of time.

 

The success of insulin injection therapy and the adherence to it depends on several factors such as a smooth insulin initiation process with counselling that alleviates the fear of needles, the insulin regime, length of needle and the method of administration. Shorter needles can provide safety from injecting into muscle, as an insulin injection in the muscle may lead to hypoglycemia.