Misadministration of Insulin: How Much of a Problem?
SOURCE: Trief PM, et al. Incorrect insulin administration: A problem that warrants attention. Clin Diabetes 2016;34:25-33.
According to data reported by the CDC in 2015, insulin is a component of the glycemic control regimen of approximately one-third of all diabetics. Because hypoglycemia is responsible for a significant number of emergency care visits, misadministration of insulin (e.g., incorrect dosing, missing meals, inappropriate dose escalation, inappropriate injection administration, or rotation) is often a cause.
To clarify the role of insulin misadministration among experienced users, Trief et al contacted 60 adults who had self-administered insulin for at least 2 years (mean = 15 years). The authors asked these individuals to demonstrate their insulin injection technique. More than 90% of participants reported they were moderately-very confident in their ability to properly inject insulin.
Investigators found that syringe users made fewer errors in preparation and drawing insulin than insulin pen users. About 20% of the time, users drew an incorrect dose. Over 25% of subjects did not consistently rotate injection sites. More than 10% of participants acknowledged using expired insulin.
These experienced insulin users were highly confident in the correctness of their insulin administration. The authors suggested that the insights provided by this study should prompt providers to ask for a demonstration of insulin administration technique, even in highly experienced users.
Providers should ask for a demonstration of insulin administration technique, even in highly experienced users.
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