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- Hanås, Ragnar, et al.
(författare)
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Experience of pain from insulin injections and needle-phobia in young patients with IDDM
- 1997
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Ingår i: Practical Diabetes International. - : Wiley. - 1357-8170 .- 1528-252X. ; 14:4, s. 95-99
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Tidskriftsartikel (refereegranskat)abstract
- We studied attitudes towards insulin injections, needle-phobia and the experience of pain when using syringes, pens, insulin pumps and in-dwelling subcutaneous catheters (Insuflon®, Maersk Medical, Lynge, Denmark).185 children and adolescents with IDDM aged 14.2±4.1 years with a HbA1c of 6.4±1.4% answered a questionnaire using 10 cm VAS scores (0 cm = hardly noticeable pain/not scared of needles at all, 10 cm=unbearable pain, very scared of needles).The VAS score of injections (median and quartiles) with syringes was 1.9 (1.1, 3.5) cm, with pens 0.4 (0.0, 1.3) cm, with in-dwelling catheters 0.4 (0.2, 1.7) cm, when taking a bolus dose with insulin pump 0.0 (0.0, 0.0) cm and when taking a blood glucose test 0.7 (0.1, 2.4) cm. The injection pain declined with increasing age but still several teenagers regarded the injection pain as almost unbearable. Injection pain correlated to HbA1c (p=0.033), age (p=0.0003), their own (p<0.0001) and their mother's (p=0.032) needle-phobia (but not father's) but not to diabetes duration or if parents had tried injections or blood glucose testing. Median needle-phobia score was 0.4 (0.1, 1.4) cm. Overall, 8.3% of the patients, 16.8% of the mothers and 17.7% of the fathers defined themselves as having pronounced needle-phobia (⩾5 cm). Those using in-dwelling catheters reported a higher needle-phobia but their injection pain was in the same low range as for other individuals.We conclude that, for most patients, the pain when injecting insulin is quite small irrespective of injection mode, but for some it is almost unbearable. Parents' attitudes are important for children's acceptance of injections. Injections through an in-dwelling injection aid enables children and adolescents to reduce the pain to levels comparable to those who are less needle-phobic.
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| 2. |
- Hanås, Ragnar, et al.
(författare)
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Unchanged Insulin Absorption After 4 Days' Use of Subcutaneous Indwelling Catheters for Insulin Injections
- 1997
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 20:4, s. 487-490
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE Since 1985, we have used indwelling catheters (Insuflon, Maersk Medical, Lynge, Denmark; Chronimed, Minnetonka, MN) to lessen pain when injecting insulin. However, some patients experience a rise in blood glucose after using indwelling catheters for a few days. We therefore studied the absorption of 125I-labeled insulin when using indwelling catheters.RESEARCH DESIGN AND METHODS Five men and five women participated (age 18–25 years, C-peptide negative, HbA1c 9.0 ± 1.0% [mean ± SD, DCA-2000 method], diabetes duration 5–21 [median 9.5] years). After thyroid blockage with potassium iodide, we injected 5IU of 125I-labeled short-acting insulin subcutaneously in the abdomen (“ordinary injection”) and 5 IU on the contralateral side through an indwelling catheter (“catheter injection”). The injection/insertion area was free of lipohyper- and lipohypotrophies. Disappearance rate was measured for 180 min with a gamma camera. The patients injected all premeal injections of short-acting insulin through the same indwelling catheter in the following 4 days. The investigation procedure was repeated day 3 and 5.RESULTS We found no statistically or clinically (95% CI) significant difference in residual activity of 125I-insulin after 60 min or in time for 50% of the injected depot to disappear (T-50%) among catheter injections on day 1, 3, and 5; ordinary injections on days 1, 3, and 5; or catheter and ordinary injections on days 1, 3, and 5, respectively. HbA1c correlated both to T-50% (r = 0.73, P = 0.016) and residual activity of 125I-insulin after 60 min (r = 0.69, P = 0.028), indicating that patients with a slower absorption will have a less ideal metabolic control when using premeal bolus injections.CONCLUSIONS We conclude that using indwelling subcutaneous catheters for insulin injections for up to 4 days does not affect the absorption of short-acting insulin.
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