SYSTEMATIC INSPECTION OF INSULIN INJECTION SITES FOR LOCAL COMPLICATIONS RELATED TO INCORRECT INJECTION TECHNIQUE

We systematically inspected insulin injection sites in 100 insulin-req uiring patients attending the Diabetic Clinic of the Tikur Anbassa Hos pital (TAH) in order to identify local complications related to incorr ect injection technique: local complications were found in 53 cases: s kin hyperpigmentation and/or indurations in 30 patients; and fat atrop hy or hypertrophy in 31 patients. Illiteracy was significantly more co mmon among those with local complications (18/53 versus 6/47, chi(2) 5 .03, P<0.05). Mean fasting blood glucose on the day of the inspection was significantly higher (14.9 + 6.3 mmol/l versus 10.5 + 6.1 mmol/l, P<0.001) and a fasting blood glucose > 10 mmol/l more common (41/53 ve rsus 20/47, chi(2) 14.1, P<0.0005) in those with than in those without local complications. There was no significant difference between the two groups in mean duration of diabetes (6.9 + 5.6 years versus 6.6 5.8 years), frequency of hypoglycaemic episodes (12/53 versus 5/47, ch i(2) 1.76, P>0.05) or mean daily insulin dose (44 + 18 units versus 44 + 22 units per day). Therefore, we concluded that local complications resulting from incorrect injection technique, a common finding in the group of patients studied, may be common among insulin requiring diab etic patients in general. Incorrect insulin injection causes local com plications and disfigurement which may compromise compliance. Furtherm ore, insulin absorption tends to be erratic from intradermal and fat h ypertrophy sites thus interfering with effective diabetic control. Ins ulin injection sites should be inspected routinely to detect and corre ct faulty technique promptly.