New Guidance Focuses on Best Injection Practices for Diabetes

Miriam E Tucker

May 30, 2017

A new set of recommendations from the United Kingdom aims to establish best practice for injecting insulin and other diabetes medications.

The Forum for Injection Technique (FIT) was founded in 2009 by a group of diabetes specialist nurses and now has separate governing boards in the United Kingdom, Canada, Switzerland, India, and South Africa, with representatives from elsewhere in the world. International guidelines were released in 2010.

Now, a new UK-specific revision has been developed and will be revised on an annual basis..

Currently, approximately 800,000 of the nearly 3 million UK residents with diabetes are on injectable therapies — either insulin or glucagonlike peptide (GLP)-1 agonists.

The 47-page document covers such issues as overcoming the psychological challenges of injections, therapeutic education, the injection process, technology, and safety.

A final chapter summarizes key aspects as a set of "Golden Rules," including offering patients counseling for injection fears, injection into subcutaneous tissue and avoiding intramuscular injections, use of the smallest pen needles possible (4 mm is recommended), rotation and inspection of injection sites to avoid lipohypertrophy, special considerations for injections in children, guidance on insulin infusions via pumps (including changing the site at least every 3 days), and instructions for safe needle disposal.

Both the development of FIT and the subsequent UK recommendations were sponsored by BD Medical–Diabetes Care and endorsed by pharmaceutical companies that manufacture insulin and GLP-1 agonists.

According to nurse consultant Debbie Hicks, FIT UK board chair, and colleagues, "FIT is committed to supporting the implementation of the recommendations by all those involved in diabetes care and to developing the recommendations further. We welcome any comments, suggestions, and active participation in ensuring that the recommendations remain relevant and useful for now and the future."  

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