Experts call for diabetes ‘tune up’ to avoid future health risks

If you don’t have diabetes, the thought of injecting yourself every day might be your worst nightmare, but a survey of 134 New Zealanders who are doing exactly that has found they’re just getting on with it.¹

In fact, they may have become a bit too relaxed about how they inject their diabetes medication with the results revealing many are not following recommendations¹.

More than one third (37%) of people surveyed are not using the recommended shorter needles, an alarming 86% are re-using their needles, and as many as 64% are not changing their injection site every time - increasing the risk of serious complications like hypoglycaemia.²

In light of these findings, experts are advising people to visit to their healthcare professional for an annual ‘tune-up’ to help address any habits that could make managing diabetes more difficult.

The survey, sponsored by Becton Dickinson (BD), also showed that most respondents experience pain (90%) and bruising (89%) from time to time as a result of injecting their medication. Dr Helen Snell, Nurse Practitioner at the Diabetes and Endocrinology Service at Midcentral District Health Board, Palmerston North, said that some of the practices seen in the survey could be putting people at risk of not achieving optimal blood glucose control and they may not realise it.

“Think of it like your annual vehicle inspection – many of us drive our cars every day and may not notice things that need fine-tuning to prevent them from becoming a bigger problem,” she said. “There are simple adjustments that can be made when injecting your diabetes medication that can make a huge difference to both the comfort of administering it, and how effective it is,” she said.

Diabetes is New Zealand’s largest and fastest growing health issue, with over 240,000 people currently diagnosed (mostly with type 2 diabetes) and an estimated 100,000 people are living with type 2 diabetes but don’t know it³. The prevalence has been rising at an average of 7% per year for the last eight years⁴
.
As many as 22% of all New Zealanders diagnosed with diabetes require injectable therapy,⁵ some having to inject multiple times a day depending on the type of diabetes and the diabetes medication requirements across the day^6,7. Not following the ‘golden rules’ for injecting - like re-using needles and always injecting into the same area - can lead to the development of lumps under the skin that affect medication absorption, with a greater risk of hypoglycaemia.²

“Over one third of respondents are using 6mm and 8mm pen needles, which is concerning. Longer needles are more likely to reach the muscle layer - which can make injecting painful and can also affect the way medication is absorbed," said Helen.

The survey also revealed that those under 50 years of age are feeling the burden of managing their diabetes more keenly than the older age group, with 71% saying that injecting medication has an ‘extreme’ or ‘moderate’ impact on their daily lives and 58% feeling as if there is no escape from being someone with diabetes.

The under 50-year age group, who are more likely to have type 1 diabetes, particularly struggled with public perceptions, with 44% feeling judged by others for having diabetes or have been made to feel that they are responsible for their diabetes.

They were also significantly less likely than those over 50 to be trying to live a healthy life by eating well and exercising (42% vs 60%), and find it irritating when people give diabetes advice (47% vs 28%). Diabetes New Zealand CEO, Heather Verry, said that although people with diabetes can and do live active and healthy lives, living with the condition can sometimes be difficult.

“Maintaining a positive attitude towards the management of diabetes is essential to understanding and learning more about the condition and how an individual can best tailor their lifestyle choices and make informed decisions on their diabetes medication,” said Mrs Verry.

Helen Snell added that people may not realise technology has advanced for something as simple as needles.

If you have been injecting medication for a while and haven’t been back to see your diabetes care provider for more than a year, ask for a review. There may be things we can do to help improve your treatment experience,” she said.

About the survey
The BD Diabetes Survey was carried out in November 2018 with 134 New Zealanders who use injectable medication for their diabetes. This sample size gives a confidence level of ± 8.4% @ 95% confidence level. Research participants came from an online permission-based panel. The sample included 89 people with Type 1 diabetes and 45 with Type 2 diabetes. Pen needle users made up 96% of the sample with 4% using syringes. There were 77 respondents aged under 50 years and 57 aged 50 years or older.

About BD
BD is one of the largest global medical technology companies in the world and is advancing the world of health by improving medical discovery, diagnostics and the delivery of care. The company supports the heroes on the frontlines of healthcare by developing innovative
technology, services and solutions that help advance both clinical therapy for patients and clinical process for healthcare providers. BD and its 65,000 employees have a passion and commitment to help enhance the safety and efficiency of clinicians' care delivery process,
enable laboratory scientists to accurately detect disease and advance researchers' capabilities to develop the next generation of diagnostics and therapeutics.

BD has a presence in virtually every country and partners with organizations around the world to address some of the most challenging global health issues. By working in close collaboration with customers, BD can help enhance outcomes, lower costs, increase efficiencies, improve safety and expand access to healthcare. In 2017, BD welcomed C. R.Bard and its products into the BD family.

For more information on BD, please visit bd.com.
References:
1. Diabetes and injection management – New Zealand. December 2018. Information on file

2. Frid AH, Kreugel G, Grassi G, et al. Mayo Clin Proc. 2016;91(9):1231–1255.

3. Ministry of Health. Diabetes. Viewed 12 December 2018. Available at:
https://www.health.govt.nz/your-health/conditions-and-treatments/diseasesand-illnesses/diabetes

4. New Zealand Ministry of Health. Living Well with Diabetes: A plan for people at high risk of or living with diabetes 2015–2020. Accessed December 2018.

Available at https://www.health.govt.nz/our-work/diseases-andconditions/diabetes/living-well-diabetes-2015-2020

5. Health Quality and Safety Commission New Zealand. Atlas of Healthcare variation: diabetes.
Accessed December 2018. Available at https://www.hqsc.govt.nz/our-programmes/healthquality-evaluation/projects/atlas-of-healthcare-variation/diabetes/

6. Diabetes New Zealand. Understand type 1 diabetes. Accessed 2 August 2018. Available at https://www.diabetes.org.nz/type1diabetes/

7. Diabetes New Zealand. Understand type 2 diabetes. Accessed 2 August 2018. Available at https://www.diabetes.org.nz/understand-type-2-diabetes/