<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_abm-2018-0028_s_005_w2aab3b7b3b1b6b1aab1c17b1Aa"><h3>Background</h3><p>The burden of diabetes has increased rapidly with an increasing cost of treatment.</p></sec><sec id="j_abm-2018-0028_s_006_w2aab3b7b3b1b6b1aab1c17b2Aa"><h3>Objectives</h3><p>To describe the glycemic control, injection practices, and treatment adherence among diabetic patients treated with insulin.</p></sec><sec id="j_abm-2018-0028_s_007_w2aab3b7b3b1b6b1aab1c17b3Aa"><h3>Methods</h3><p>This cross-sectional study was conducted using a convenience sampling method at the 3 tertiary referral hospitals in Bhutan. Sociodemographic, injection practices, and clinical details were collected. Good glycemic control was defined as glycated hemoglobin A (HbA<sub>1c</sub>) &lt;7% if available or fasting blood sugar 70–130 mg/dL and 2 h postprandial blood sugar &lt;180 mg/dL if HbA<sub>1c</sub> values were unavailable. Medication adherence was assessed using the Morisky, Green and Levine (MGL) scale. The injection technique was assessed using a 10-item checklist.</p></sec><sec id="j_abm-2018-0028_s_008_w2aab3b7b3b1b6b1aab1c17b4Aa"><h3>Results</h3><p>We studied 207 patients. Good glycemic control was achieved by only 58 (28.0%) of patients. Using the MGL scale score, the objective adherence with insulin therapy was mostly low to medium and a gross discordance was with self-declared adherence (<italic>P</italic> &lt; 0.001). The injection technique was fair to poor in half of the participants. Those with good injection techniques also had good adherence to medication (<italic>P</italic> = 0.025, adjusted odds ratio = 4.4, 95% confidence interval 1.2–16.4). The majority (154, 74.4%) had self-injected insulin, while the remaining were dependent on their home caregivers. Forty percent of the participants used storage practices that were not recommended. The disposal of the used insulin needles was generally unsafe.</p></sec><sec id="j_abm-2018-0028_s_009_w2aab3b7b3b1b6b1aab1c17b5Aa"><h3>Conclusions</h3><p>Glycemic control and adherence to insulin administration recommendations were poor. The injection technique needs to be improved and standardized, and methods of safe disposal of sharps need to be developed.</p></sec></abstract>

BackgroundThe burden of diabetes has increased rapidly with an increasing cost of treatment.ObjectivesTo describe the glycemic control, injection practices, and treatment adherence among diabetic patients treated with insulin.MethodsThis cross-sectional study was conducted using a convenience sampling method at the 3 tertiary referral hospitals in Bhutan. Sociodemographic, injection practices, and clinical details were collected. Good glycemic control was defined as glycated hemoglobin A (HbA1c) <7% if available or fasting blood sugar 70–130 mg/dL and 2 h postprandial blood sugar <180 mg/dL if HbA1c values were unavailable. Medication adherence was assessed using the Morisky, Green and Levine (MGL) scale. The injection technique was assessed using a 10-item checklist.ResultsWe studied 207 patients. Good glycemic control was achieved by only 58 (28.0%) of patients. Using the MGL scale score, the objective adherence with insulin therapy was mostly low to medium and a gross discordance was with self-declared adherence (P < 0.001). The injection technique was fair to poor in half of the participants. Those with good injection techniques also had good adherence to medication (P = 0.025, adjusted odds ratio = 4.4, 95% confidence interval 1.2–16.4). The majority (154, 74.4%) had self-injected insulin, while the remaining were dependent on their home caregivers. Forty percent of the participants used storage practices that were not recommended. The disposal of the used insulin needles was generally unsafe.ConclusionsGlycemic control and adherence to insulin administration recommendations were poor. The injection technique needs to be improved and standardized, and methods of safe disposal of sharps need to be developed.

Glycemic control, medication adherence, and injection practices among diabetic patients treated in the 3 tertiary referral hospitals in Bhutan: a call for more action

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

BackgroundThe burden of diabetes has increased rapidly with an increasing cost of treatment.ObjectivesTo describe the glycemic control, injection practices,...

Glycemic control, medication adherence, and injection practices among diabetic patients treated in the 3 tertiary referral hospitals in Bhutan: a call for more action

Article Category: Brief communication (original)

Published Online: Dec 31, 2018

Page range: 27 - 33

DOI: https://doi.org/10.1515/abm-2018-0028

Keywords
Bhutan, developing countries, diabetes mellitus, insulin, medication adherence

© 2018 Thinley Dorji et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Glycemic control, medication adherence, and injection practices among diabetic patients treated in the 3 tertiary referral hospitals in Bhutan: a call for more action

Article Category: Brief communication (original)

Published Online: Dec 31, 2018

Page range: 27 - 33

DOI: https://doi.org/10.1515/abm-2018-0028

KeywordsBhutan, developing countries, diabetes mellitus, insulin, medication adherence

© 2018 Thinley Dorji et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
Bhutan, developing countries, diabetes mellitus, insulin, medication adherence