Title:Challenges with Insulin Use Among Patients with Type 2 Diabetes Mellitus: Focus on a Tertiary Healthcare Setting in South-East Nigeria
Volume: 13
Issue: 2
Author(s): Ezeani Ignatius U., Onyeonoro Ugochukwu U., Ugwu Theophilus E., Abali Chuku and Eregie Aihanuwa
Affiliation:
Keywords:
Insulin, blood glucose, hypoglycaemia, storage, challenges.
Abstract: Background: Effective usage of insulin in the management of diabetes remains a challenge
in developing countries like Nigeria.
Objective: The objective of this study is to document the pattern of insulin prescription, frequency,
storage, common regimen used, and attendant problems associated with its use in patients with type
2 diabetes mellitus (T2DM).
Methods: This was a prospective, descriptive study in which consecutive T2DM patients seen at the
medical out-patient clinic and medical wards and who fulfilled the criteria for inclusion were recruited.
Participants provided information on their demographic characteristics, diabetes history,
treatment and problems associated with treatment, type of insulin in use, number of daily injections,
storage, method of insulin administration and problems associated with insulin use. Clinical examination
was carried out basically to determine the anthropometric indices.
Results: About 84.3% have used insulin for less than 5 years. The thigh was the commonest site of
insulin administration (95.3%). About 94.3% of subjects in this study store their insulin in a refrigerator.
And Insulin dosing regimen ranged from less than once to four times daily while majority of
patients (63%) were on twice daily insulin regimen. Insulin administration devices used were Insulin
syringes 394 (98.5%) and Insulin pens 6 (1.5%). Thirty three percent of the subjects self inject insulin
while about half of the study subjects (50.5%) receive insulin from a healthcare provider. The
most common insulin used by patients was Mixed/ Premixed insulin (32.8%) and Regular/ Soluble
insulin (38.8%). Hypoglycaemia was the most frequently documented problem encountered by subjects
on insulin followed by weight gain. Majority of the study subjects (50.8%) practice self monitoring
of blood glucose (SMBG).
Discussion: This study has demonstrated that majority of subjects with T2DM were on premixed insulin
and that hypoglycaemia is the most common problem reported by patients. Insulin pens were
not common among our study population.