Effectiveness of Insulin Injection Technique on Glycemic Control of Fasting Plasma Glucose and HbA1c in Type II DM Patients at Hasanuddin University Hospital. Randomized Controlled Trial

Authors

  • Herlina Semi Hasanuddin University Hospital, Makassar, Indonesia
  • Sitti Musdalifah Ahmad Hasanuddin University Hospital, Makassar, Indonesia https://orcid.org/0000-0002-9119-4765
  • Meylani Tuti Hasanuddin University Hospital, Makassar, Indonesia
  • Alif Muhammad Islam Faculty of Nursing, Hasanuddin University, Makassar, Indonesia

DOI:

https://doi.org/10.20956/icon.v9i2.42527

Keywords:

Insulin injection technique, glycemic levels, Fasting Plasma Glucose, HbA1c, Type II DM patients

Abstract

Aims: To identify the effectiveness of insulin injection techniques (injection method, injection location, insulin pen, and drug dose) on glycemic control of HbA1c and Fasting Plasma Glucose (FPG) in Type II DM patients.

Methods: The design of this study was quantitative experimental using a Randomized Controlled Trials (RCT) research design with non-blinding in patients with Type II Diabetes Mellitus who had received insulin therapy. The sample consisted of 60 Type II DM patients and consisted of 30 intervention groups and 30 control groups.

Results: There were significant results on the level of knowledge (p=0.043), accuracy of insulin use (p=0.002), and insulin injection skills (p= 0.017) in patients in the intervention group before and after education, but there was no significant difference in the control group. In addition, in the intervention group, there was a substantial and controlled decrease in GDP and HbA1c levels with a value of p = 0.000, while in the control group, there were no significant results with p=0.104.

Conclusion: Insulin injection techniques (injection method, injection location, insulin pen, and drug dose) can significantly control FPG and HbA1c glycemic levels in Type II DM patients.

References

Abujbara, M., Khreisat, E. A., Khader, Y., & Ajlouni, K. M. (2022). Effect of insulin injection techniques on glycemic control among patients with diabetes. International Journal of General Medicine, 15, 8593–8602. https://doi.org/10.2147/IJGM.S393597

American Diabetes Association. (2020, December 19). ADA releases 2021 standards of medical care in diabetes centered on evolving evidence, technology, and individualized care. https://diabetes.org/newsroom/ADA-releases-2021-standards-of-medical-care-in-diabetes

American Diabetes Association. (2024). Facilitating positive health behaviors and well-being to improve health outcomes: Standards of care in diabetes—2024. Diabetes Care, 47(Suppl. 1), S77–S110. https://doi.org/10.2337/dc24-S005

American Diabetes Association. (2025). Glycemic goals and hypoglycemia: Standards of care in diabetes—2025. Diabetes Care, 48(Suppl. 1), S128–S145. https://doi.org/10.2337/dc25-S006

Barnard-Kelly, K. D., Mahoney, E., Baccari, L., Oliveria, T., Glezer, S., Berard, L., et al. (2021). Injection technique: Development of a novel questionnaire and user guide. The American Diabetes Association Journal, 34(2), 156–165. https://doi.org/10.2337/figshare.13237364

Bari, B., Corbeil, M. A., MacNeill, G., Puebla-Barragan, S., & Vasquez, A. (2023). Addressing insulin injection technique: A follow-up study of Canadian patients with diabetes. Diabetes Therapy, 14(12), 2057–2074. https://doi.org/10.1007/s13300-023-01479-1

Djahido, M., Wiyono, W. I., & Mpila, D. A. (2020). Insulin use patterns in type 1 diabetes mellitus patients in the outpatient installation of Prof. Dr. R. D. Kandou Manado General Hospital. PHARMACON Scientific Journal of Pharmacy UNSRAT, 9(1). https://doi.org/10.35799/pha.9.2020.27413

Ehrmann, D., Kulzer, B., Wienbarg, I., Sieber, J., Weber, S., Haak, T., et al. (2023). Assessing barriers and adherence to insulin injection technique in people with diabetes: Development and validation of new assessment tools. Journal of Diabetes Science and Technology. https://doi.org/10.1177/19322968231175920

Gorska-Ciebiada, M., Masierek, M., & Ciebiada, M. (2020). Improved insulin injection technique, treatment satisfaction, and glycemic control: Results from a large cohort education study. Journal of Clinical and Translational Endocrinology, 19. https://doi.org/10.1016/j.jcte.2020.100217

Kalra, S., Pathan, F., Kshanti, I. A. M., Bay, N. Q., Nagase, T., Oliveria, T., et al. (2023). Optimizing insulin injection techniques to improve diabetes outcomes. Diabetes Therapy, 14, 1785–1799. https://doi.org/10.1007/s13300-023-01460-y

Kamrul-Hasan, A. B. M., Hannan, M. A., Asaduzzaman, M., Rahman, M. M., Alam, M. S., Amin, M. N., et al. (2022). Prevalence and predictors of diabetes distress among adults with type 2 diabetes mellitus: A facility-based cross-sectional study of Bangladesh. BMC Endocrine Disorders, 22(1). https://doi.org/10.1186/s12902-022-00938-3

Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Kaabi, J. A. (2020). Epidemiology of type 2 diabetes - Global burden of disease and predicted trends. Journal of Epidemiology and Global Health, 10(1), 107–111. https://doi.org/10.2991/JEGH.K.191028.001

Liang, K., Xie, Q., Nie, J., & Deng, J. (2021). Study on the effect of education for insulin injection in diabetic patients with new simulation tools. Medicine (United States), 100(14), E25424. https://doi.org/10.1097/MD.0000000000025424

Masierek, M., Nabrdalik, K., Janota, O., Kwiendacz, H., Macherski, M., & Gumprecht, J. (2022). The review of insulin pens—Past, present, and look to the future. Frontiers in Endocrinology, 13. https://doi.org/10.3389/fendo.2022.827484

Mehrabbeik, A., Namiranian, N., Azizi, R., Meybody, M. A., Shariati, M., & Kohani, H. A. M. (2022). Investigation of association between insulin injection technique and blood glucose control in type 2 diabetes patients. International Journal of Endocrinology and Metabolism, 20(4). https://doi.org/10.5812/ijem-128392

Mobasseri, M., Shirmohammadi, M., Amiri, T., Vahed, N., Fard, H. H., & Ghojazadeh, M. (2020). Prevalence and incidence of type 1 diabetes in the world: A systematic review and meta-analysis. Health Promotion Perspectives, 10, 98–115. https://doi.org/10.34172/hpp.2020.18

Selvadurai, S., Cheah, K. Y., Ching, M. W., Kamaruddin, H., Lee, X. Y., & Ngajidin, R. M., et al. (2021). Pharmacist insulin injection re-education impacts glycemic control among type II diabetic patients in primary health clinics. Saudi Pharmaceutical Journal, 29(7), 670–676. https://doi.org/10.1016/j.jsps.2021.04.028

Soetmadji, D. W. (2021). Practical guidelines for insulin therapy in patients with diabetes mellitus (1st ed.).

Trief, P. M., Cibula, D., Rodriguez, E., Akel, B., & Weinstock, R. S. (2023). Incorrect insulin administration: A problem that warrants attention. Clinical Diabetes, 34(1), 25–33. https://doi.org/10.2337/diaclin.34.1.25

Tulsan, S. K., et al. (2024). Errors in diabetic insulin therapy and the vitality of proper precautions in Bangladesh: Real-life insights from the developing world. Journal of Family Medicine and Primary Care, 13(1), 292–297. https://doi.org/10.4103/jfmpc.jfmpc_484_23

Ucieklak, D., et al. (2022). Insulin-induced lipohypertrophy in patients with type 1 diabetes mellitus treated with an insulin pump. International Journal of Endocrinology, 2022. https://doi.org/10.1155/2022/9169296

Vickerstaff, V., Omar, R. Z., & Ambler, G. (2019). Methods to adjust for multiple comparisons in the analysis and sample size calculation of randomized controlled trials with multiple primary outcomes. BMC Medical Research Methodology, 19(1). https://doi.org/10.1186/s12874-019-0754-4

Wu, Q., Deng, M., Wang, W., Yu, S., Wang, M., Sun, C., et al. (2023). A self-controlled, cross-over study of intensive insulin treatment with needle-based injection versus needle-free injection in hospitalized patients with type 2 diabetes. Frontiers in Endocrinology (Lausanne), 14. https://doi.org/10.3389/fendo.2023.1162176

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Published

2025-02-27

How to Cite

Semi, H., Ahmad, S. M., Tuti, M., & Islam, A. M. (2025). Effectiveness of Insulin Injection Technique on Glycemic Control of Fasting Plasma Glucose and HbA1c in Type II DM Patients at Hasanuddin University Hospital. Randomized Controlled Trial . Indonesian Contemporary Nursing Journal (ICON Journal), 9(2), 134–143. https://doi.org/10.20956/icon.v9i2.42527

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