Impacts of insulin storage and injection techniques intervention on glycemic control among patients with diabetes in northwest Ethiopia: a quasi-experimental study

Abstract

Background: Proper storage of insulin and accuracy of injection technique are essential for maintaining the effectiveness of insulin and optimizing glycemic control. In resource-poor countries like Ethiopia, poor storage conditions and incorrect injection techniques are prevalent, and hence, less than desired glycemic results are obtained. Interventional studies aimed at addressing these problems in Ethiopia are lacking. Objectives: This study aimed to evaluate the effect of an educational intervention on glycemic control, insulin storage behavior, and injection practices among diabetic patients at Debre Tabor Hospital. Design: A quasi-experimental pre- and post-intervention study design was employed. Methods: The study was conducted at Debre Tabor Hospital from January to June 2024. Baseline data on insulin storage, injection practices, and fasting blood glucose levels were collected using structured questionnaires and clinical records. The intervention was educational conferences with demonstrations and take-home materials on appropriate injection and storage practices. A follow-up after 3 months was carried out to determine changes in glycemic control and practice change. The intervention's efficacy was determined by analyzing data using STATA version 17 with logistic regression and McNemar's test. Results: = 0.001). Lipohypertrophy occurred in 40.9% of patients, predominantly in the arm. Poor glycemic control at the baseline was significantly associated with variables like age (adjusted odds ratio (AOR) = 2.254), polypharmacy (AOR = 2.321), poor injection angle (AOR = 2.311), and inappropriate storage (AOR = 2.675). After the intervention, only age (AOR = 1.504) and polypharmacy (AOR = 1.976) maintained significance. Conclusion: The educational intervention successfully enhanced the insulin injection and storage procedures, thereby achieving improved glycemic control results. However, glycemic outcomes were still adversely affected by enduring factors of age and polypharmacy. This justifies the need for continuous education and individualized interventions to handle both unchangeable patient factors and mutable behaviors.