Forum for Injection Technique (FIT) has released its latest recommendations for insulin injection usage.  The effort coincided with the 93rd anniversary of first successful insulin administration on 11th January 1921, at Toronto General Hospital, Canada.

The key objective of the recommendations is to  combat Psychological Insulin Resistance (PIR) or resistance to initiating insulin therapy and to commemorate the
 
On this occasion, doctors from various hospitals including Bangalore Diabetes Hospital, Apollo Hospital and Advisory Board members of Forum for Injection Technique provided tips on overcoming needle phobia for insulin injection dependent patients. Studies show that more than 80 per cent of people have psychological resistance to even initiate an insulin therapy, despite it being indispensable for glycemic control to manage the disease.

As per the new recommendations, special emphasis is to be given to counter allergic reactions arising out of incorrect usage of injections and usage in special groups like pregnant women and people with weak immunity. In pregnant women, injections should be given into the abdomen using a raised skin-fold. In the first trimester women should be reassured that no change in insulin site or technique is needed. In the second trimester lateral parts of the abdomen can be used to inject insulin, staying away from the skin overlying the fetus. In the third trimester, insulin can be injected over the abdomen while ensuring the skin fold is properly raised. Apprehensive patients may use the thigh or upper arm to inject themselves.

Highlighting on the need to adopt correct injection technique, Dr. Prasanna Kumar, senior endocrinologist and CEO, Bangalore Diabetes Hospital said that most  people are unaware of the complications of  incorrect insulin administration.  There is need for proper education on  how to give an insulin shot correctly. If administered incorrectly, lipohypertrophy is a commonly occurring complication which can be  disturbing for patients.

The FIT recommendations also suggest that correct injection technique can help protect against lipohypertrophy (LH), unexplained hypoglycemia or (low blood sugar) and blood glucose variation. Shorter needles can provide safety from injecting into muscle, as an insulin injection in the muscle may lead to hypoglycemia. Several factors including regular inspection of injection sites, preventing reuse of needle, correct site rotation, influence the success of insulin injection therapy.

“For children with diabetes, insulin injection is the only treatment and they do not have with choice in this regard. It is important to understand where insulin should be injected in the body. FIT2.0 talks about best practices such as using a new needle for every injection, always rotating injection sites and more, ” Dr Anjana Hulse, Consultant, Paediatric Endocrinology, Apollo Hospital.