Practices Regarding Use of Insulin among Diabetic Patients in Five Selected Hospitals in Colombo District, Sri Lanka

Abstract

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Diabetes mellitus is recognized as one of the leading cause of death and disability worldwide. The objective of the study was to assess the practices of insulin therapy among patients who were on insulin. A descriptive cross sectional study was conducted among diabetic patients aged 18 years and above who were on insulin, attending diabetic/medical clinic in five hospitals in Colombo district. A pretested, interviewer-administered, structured-questionnaire was used to collect data. Out of the total 400 respondents the majority (29.0%) was on insulin for V - 2 years and 44.75% had completed their education only up to ordinary level. Less than half of the study subjects (47.2%) had checked their HbAlc level at least once, showing that poor practice on HbAlc testing. More than half (56.2%) of the total population had never used a glucometer though it plays a vital role in diabetic management. Slightly less than two third of the study subjects (65.0%) did not self- adjust insulin doses as per their concern. There was no significant association between duration of insulin therapy and confidence on self- administering insulin (p=0.423). The majority (94.5%) of the total study group stored their insulin in the refrigerator which showed a good storage practice. Though 95.8% of study subjects managed hypoglycemia at the home only 36.2% knew at least three symptoms of hypoglycemia. Relatively half of the total population 49.8% did not carry sweets when going out, for managing emergency hypoglycemic attacks. Two fifth of the participants (40.0%) did not carry any symbol indicating that they were using insulin. Although practices regarding some questioned areas on insulin therapy can be satisfied, yet there are areas which need to be further improved. Provision of careful counseling initially and repetitively may lead to better glycemic control and improved quality of life