Utilización correcta de los dispositivos de insulina en el control de la diabetes tipo II y factores asociados

Purpose: to describe the use of insulin devices in patients with diabetes mellitus and the relationship of potential associated factors with the correct or incorrect use of such devices.

Methods: a cross-sectional descriptive study. Study setting: a metropolitan Primary Care Center in Hospitalet de Llobregat, Barcelona. Patients with insulin-dependent type 2 diabetes mellitus, aged ≥ 50 years. Random sample calculation (n= 168 with 95%CI, precision ±5%) to estimate a predicted 80% population rate and a 10% replacement rate. Non-probabilistic systematic sampling. Variables: correct handling of the insulin device, sociodemographic characteristics, treatment-related characteristics and adherence to insulin therapy, comorbidities, fears and reluctances. A descriptive univariate and bivariate analysis.

Results: 162 patients with insulin-dependent diabetes mellitus; 59.3% were correctly administering insulin. 51.8% reported skin problems, which were related to a higher number of punctures (p= 0.027). 50% reported having forgotten to take their insulin (p= 0.001). 38.1% said that, occasionally, they had not remembered the instructions given by their health professional regarding the use of insulin (p= 0.021). Among the patients with visual impairment, 22.9% reported difficulties to administer insulin once loaded into the device (p = 0.038). Among patients with handling impairment, 21.5% had hand tremors while loading insulin (p= 0.001) and 26.2% reported that once loaded they had difficulty administering it (p= 0.012).

Conclusions: several factors result in mistakes in insulin self-administration, which suggests the need for a verified regular review of the administration method and re-education on the correct self-administration to promote treatment adherence