Enhancing glycaemic control for diabetics

Debbie Hicks, nurse consultant – diabetes, Enfield Health, Barnet, Enfield & Haringey Mental Health Trust, provides The Clinical Services Journalwith an update on new recommendations for insulin delivery.

Diabetes has now become a worldwide epidemic, and as people are diagnosed at an earlier age, yet are living longer, there is an increasing likelihood that they will need to use injectable therapies to control their condition. For those people with diabetes using injectable therapies, best practice injection technique is a crucial element of condition management as it is essential for therapies to achieve their optimal effect.1

Best practice injection technique has the ability to reduce hypoglycaemic episodes and encourage glycaemic stability.2 Poor technique can lead to injectable therapies being absorbed in an unpredictable manner.3 Immediate problems such as hypoglycaemia (if insulin is injected into muscle where it is absorbed more quickly), hyperglycaemia (if it is injected into damaged tissue where it will be poorly absorbed), and perhaps even ketoacidosis in those with Type 1 diabetes may result.4 In the longer term, poor glycaemic control can increase the risk of complications including kidney failure, blindness and limb amputation,5 all of which have a devastating impact for the individual, as well as huge cost implications.6

In light of this, the FITTER (Forum for Injection Technique and Therapy Expert Recommendations) congress was held in Rome in October 2015. FITTER was the latest in a series of scientific seminars designed to improve the management of insulin-treated diabetes for healthcare professionals and patients. The event brought together 183 diabetes experts from 54 countries, including 13 members of the FITTER Scientific Advisory Board. 

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