Insulin injection site and time interval administration for the postprandial glucose control in patient with diabetes type 2: A randomized clinical trial
,
Abstract
Background & Aim: insulin injection to the patients suffered from diabetes mellitus need to consider the dose, route, time and injection spot since it will affect to postprandial blood sugar. This study aimed to determine the effectiverness of insulin injection site and interval timing administration to the control of postprandial glucose in diabetes mellitus patients type 2.
Methods & Materials: The study was an experimental with Randomized Complete Block Design (RCBD). The population were patients with diabetes mellitus type 2 in dr. Moewardi Hospital Solo, Indonesia, consisted of 60 respondents taken from simple random sampling (allocate by inverse transform random variate generator and with Microsoft Excel), the respondents were divided into 4 blocks or groups (15 respondents/blocks). Injection used was Rapid-acting insulin with the dosage prescribed by the doctor. Injection was done in four (4) locations; abdomen, deltoid, thigh and gluteus. The administration were 0 minutes (along with meals), 10 minutes before meal, 20 minutes before meal and 30 minutes before meal. Two hour postprandial glucose levels were measured using a Glucometer. Data were then analyzed by SPSS 18 with Two-Way ANOVA and Tukey HSD.
Result: 55% of the respondents was male and 45% was female. All respondents were ≥ 40 years old, most of the respondents were in normal body weight and they have suffered the illness >10 years. There were differences in postprandial glucose levels in people with diabetes who obtained insulin injection at the site of the abdominal, deltoid, thigh and gluteus (P <0.05). There were differences in postprandial glucose levels in people with diabetes who obtained insulin injections at 0, 10, 20 and 30 minutes before meal (P <0.05). The location and the most effective time for insulin injection was in the abdomen at time 0 minute before meal (P <0.05).
Conclusion:Injection of insulin made in the abdomen by the time of meals effectively controlled postprandial glucose levels in patients with diabetes mellitus type 2.
PERKENI. Konsensus Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2. 2011. Jakarta.
Syam AF. Pemberian Insulin yang Tepat, Terhindar dari Komplikasi. 2008. Jakarta: Fakultas Kedokteran Universitas Indonesia.
Misnadiarly. Diabetes Mellitus, Gangren, Ulcer, Infeksi, Mengenali Gejala Menanggulangi Mencegah Komplikasi. 2006. Jakarta: Pustaka Populer Obor
Lindholm A, McEwen J, Riis AP. Improved Postprandial Glycemic Control With Insulin Aspart. A Randomized Double-blind Cross-Over Trial in Type 1 Diabetes. Diabetes Care. 1999;22(5):801-805.
Suwanda. Desain Eksperimen untuk Penelitian Ilmiyah. 2011. Bandung: Alfabeta
David IJ and Adehi MU. 2014. Effectiveness of Split-Plot Design over Randomized CompleteBlock Design in Some Experiments. Journal of Biology, Agriculture and Healthcare. 2014:4(19):75-80.
Clovis AP. Testing the Effect of blocking
in a Randomized Complete Block Design (RCBD). Journal Communications in Statistics - Theory and Methods Volume 10, Issue 23, 2007.p.2447-2459.
Dahlan S. Besar sampel dan Cara Pengambilan Sampel dalam Penelitian Kedoteran dan Kesehatan. 2010. Jakarta: Salemba Medika
Cochran WJ. Teknik Penarikan Sampel. 2010. Jakarta: UI Press
Rahman A. Pengacakan Random Sampling Dengan Pendekatan Inverse-Transform Random Variate Generator Berbasis Distribusi Hipergeometrik. Prosiding Seminar Nasional Teknoin. 2013:4(1): 106-111.
Salacinski AJ, Alford M, Drevets K, Hart S, Hunt BE. Validity and Reliability of a Glucometer Against Industry Reference Standards. Journal of Diabetes Science and Technology, 8(1),2014 95–99.
Widhiarso W. Analisis Varians Multivarians. 2011. Availabel from: http://widhiarso.staff.ugm.ac.id/files/Analisis%20Varians%20Multivariat.pdf
Sugiyono. Statistika untuk Penelitian. 2007. Bandung ALFABETA
Bantle JP, Neal L, Frankamp LM. Effects of the Anatomical Region Used for Insulin Injections on Glycemia in Type I Diabetes Subjects. Diabetes Case, 1993; 16:12
Suckale J, Solimena M. Pancreas Islets in Metabolic Signaling - Focus On The β-cell. Precedings Nature. 2008.
Medsafe. Novo Rapid Novo Mix Injection Presentation. New Zaeland Data Sheet. CAS No: 116094-23-6. 2012. Availabel from:http://www.medsafe.govt.nz/Profs/Datasheet/n/NovoRapidNovoMixinj.pdf
Czupryniak L, Ruxer J, Saryusz-Wolska M, Kropiwnicka A, Drzewoski J. Effect of time interval between insulin injection and meal ingestion on metabolic control in type 2 diabetes mellitus. Diabetes Research and Clinical Practice. 2000;50:66.
Coscelli C, Iacobellis G, Calderini C, Carleo R, Gobbo M, Di Mario U, et al. Importance of premeal injection time in insulin therapy: Humalog Mix25 is convenient for improved post-prandial glycemic control in type 2 diabetic patients with Italian dietary habits. Acta diabetologica. 2003;40(4):187-92.
Jovanovic L, Giammattei J, Acquistapace M, Bornstein K, Sommermann E, Pettitt DJ. Efficacy Comparison Between Preprandial and Postprandial Insulin Aspart Administration With Dose Adjustment for Unpredictable Meal Size. Clin Ther. 2004;26(9): 1492-1497.
| Files | ||
| Issue | Vol 5 No 1 (2018): Winter | |
| Section | Original Article(s) | |
| Keywords | ||
| insulin postprandial glucose diabetes type | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
