Factors related to tissue complications resulting from insulin therapy: a cross-sectional study.
Wallison Pereira Dos Santos, Mailson Marques de Sousa, Bernadete de Lourdes André Gouveia and 3 others
PMID 35112702WHAT IT FOUND
73.5% of insulin users had injection-site complications, especially bruises and lumps.
Not rotating sites was strongly linked with complications, and needle reuse was common. Nurses should assess sites and review insulin technique.
Key findings
0173.5% of participants had tissue complications on examination, and bruises with lipodystrophy were highlighted at 42.0%.
0282.3% of participants did not rotate injection sites, and not rotating was associated with a 6.70 times increase in the chance of tissue complications (95% CI 1.35 to 9.12).
03Technique errors were frequent: 24.2% did not homogenize insulin, 39.7% did so inadequately, 66.9% did not clean the injection site, and 94.1% did not keep the needle in the tissue after application.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it can show links but not cause and effect. Participants came from one endocrinology clinic and were a convenience sample, so they may not represent other insulin users. People at their first visit were excluded, so new insulin users were not included. No HbA1c data were collected, so the study cannot link technique errors to blood glucose control. Insulin administration was observed in a simulated setting, not in the person's home.
The easy way to misread this
Do not conclude that not rotating injection sites causes tissue complications. This was a cross-sectional convenience sample, so it can show associations only, not cause and effect.