Psychological problems related to capillary blood glucose testing and insulin injection among diabetes patients

Objective:This review is aimed at explaining the psychological problems related to capillary blood glucose(CBG)testing and insulin injection,as well as recommending essential strategies to solve the fear thereof.Methods:Databases,including PubMed,Cumulative Index of Nursing and Allied Health Literature(CINAHL),Scopus,and Google Scholar,were searched to extract the relevant articles.Initially,the terms used to retrieve related studies were"fear of blood glucose monitoring","anxiety capillary blood glucose testing and insulin injection","psychological problems on blood glucose monitoring and insulin injection","diabetes management",and"diabetes mellitus".Results:Results showed that the psychological problems related to CBG testing and insulin injection were associated with the stress and depression experienced during diabetes self-monitoring of blood glucose.This psychological issue has its impacts such as nonadherence to medication as well as a lack of self-discipline in terms of CBG testing and insulin injection.Inadequate information,inappropriate perception,and pain/discomfort during pricking of fingers were the main reasons for the psychological issues in CBG testing and self-injection of insulin.Conclusions:The expected benefits of this review include the explanation of the issues related to the psychological problems in CBG testing and insulin injection among type 2 diabetes mellitus(T2DM)patients.This review article also provides the recommendations on providing counseling and empowering the patients on CBG monitoring and insulin injection.Moreover,family members should provide psychological support to reduce fear,anxiety,and distress arising from CBG testing and insulin injection.

A Research About the Current Situation of Insulin Injection Provided by Clinical Nurses Under Kap Model on Linzhi, Tibet

Objective:to investigate the current situation of insulin injection provided by clinical nurses under KAP(Knowledge-Attitude-Practice)model on Linzhi,Tibet,and to discuss and analyse the influence factors.Methods:using a selfdesign questionnaire a questionnaire about the current situation of insulin injection provided by clinical nurses under KAP model on Linzhi,Tibet to investigate 268 clinical nurses in Linzhi,Tibet,who were chosen through random sampling method,in order to analyse the‘KAP’scoring and the influencing factors.Results:The scoring of‘Knowledge’is(65.642±10.313),the scoring of‘Attitude’is(55.478±8.099),the scoring of‘Practice’is(42.493±6.647),the total scoring is(163.612±19.292).The related influence factors,including hospital,department,academic credentials,professional qualifications and whether receiving diabetes specialized training,have statistical significance(P value<0.5).Conclusion:The KAP of insulin injection provided by clinical nurses in Linzhi,Tibet is on middle level.For nursing managers,it is strongly advised that a normative.

Cost-effectiveness Analysis of Insulin Degludec and Liraglutide Injection in the Treatment of Type 2 Diabetes

Objective To analyze the cost-effectiveness of insulin degludec and liraglutide injection(IDegLira)compared with insulin glargine plus insulin aspart(IGar plus IAsp)in the treatment of type 2 diabetes mellitus(T2DM)based on the price of IDegLira before and after it was successfully admitted to the National Reimbursable Drug List(NRDL).Methods Cost and effectiveness parameters were obtained through systematic retrieval from PubMed,ScienceDirect,CNKI,and Wanfang database.A cost-effectiveness analysis(CEA)model was established to analyze the economics using IDegLira for T2DM patients with 1 to 5 years of medication.Results and Conclusion Before IDegLira was admitted to NRDL,its economic advantages over the IGlar plus Iasp regimen became more significant as patients’medication time prolonged.After being admitted to NRDL,with 1 year of medication,the medical cost of IDegLira decreased by 2853.91 yuan and the quality adjusted life years(QALY)increased by 0.12055 than IGar plus IAsp.The sensitivity analysis was highly consistent with the results of the baseline result.After being admitted to NRDL,for patients with T2DM who have poor blood glucose control,IDegLira is absolutely an economic advantage scheme compared with IGar plus IAsp.

Differences in clinicopathological characteristics between lipohypertrophy and localized insulin-derived amyloidosis:A scoping review

Insulin is used as a therapeutic agent in patients with diabetes,and cutaneous lipohypertrophy(LH)and localized insulin-derived amyloidosis(LIDA)are well-known adverse effects associated with insulin injections.The clinical implications,management,assessment methods,and pathological differentiation of LH and LIDA have been recently updated.This review was to update our knowledge of the pathological differentiation,effects of insulin absorption,hypoglycemic events,and recent assessment methods for LH and LIDA.A scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses extension for Scoping Reviews guidelines.Original studies and case reports in English were also included.PubMed and Scopus databases were searched for keywords to identify papers published up to January 2022.A total of 113 studies were identified through a database search,and 31 were eligible for inclusion in this scoping review.In the 31 studies included in this review,patients with type 2 diabetes had high frequencies of LH and LIDA.LH outcome parameters were assessed using pathological findings and imaging.LIDA is mainly determined by pathological methods,such as hematoxylin and eosin and Congo red staining.Several in vitro and in vivo LIDA models of LIDA have been developed.These results suggest that pathological analysis is required to identify LH and LIDA.It is important to consider LIDA,as it likely influences insulin adsorption and glycemic control.Although several studies have evaluated the LIDA process,little is known about the mechanisms underlying the development of adverse effects associated with insulin injections.

甘露醇联合神经节苷脂注射液治疗急性高血压脑出血疗效观察

目的探讨甘露醇联合神经节苷脂注射液治疗急性高血压脑出血的临床效果及对患者认知功能和血清S100B蛋白(S100B)、胰岛素样生长因子1(IGF-1)、神经元特异性烯醇化酶(NSE)水平的影响。方法选择2015年11月至2018年1月南阳市中心医院神经内科收治的94例急性高血压脑出血患者为研究对象,按照随机数字分组法分为对照组与观察组,每组47例。2组患者均给予持续吸氧、控制惊厥、预防应激性溃疡、脱水降颅压、维持水电解质平衡等常规治疗;同时,对照组患者给予单纯甘露醇治疗,观察组患者给予甘露醇联合神经节苷脂注射液治疗,疗程均为2周。根据CT扫描结果计算2组患者治疗前后脑水肿面积及血肿体积,采用酶联免疫吸附试验检测2组患者治疗前后血清S100B、IGF-1水平,电化学发光免疫法检测2组患者治疗前后血清NSE水平。根据美国国立卫生研究院卒中量表(NIHSS)标准评定2组患者的临床效果,根据Barthel指数(BI)评估2组患者治疗前后日常生活能力,依据简易精神状态表(MMSE)判断2组患者治疗前后认知功能。结果2组患者治疗前脑水肿面积、血肿体积、NIHSS、BI、MMSE评分及血清S100B、NSE、IGF-1水平比较差异均无统计学意义(P>0.05)。与治疗前比较,2组患者治疗后脑水肿面积、血肿体积、NIHSS评分均显著减小(P<0.05),血清S100B、NSE水平显著降低(P<0.05),BI、MMSE评分均显著增高(P<0.05),血清IGF-1水平显著升高(P<0.05)。观察组患者治疗后脑水肿面积、血肿体积、NIHSS评分与对照组比较显著减小(P<0.05),BI、MMSE评分及血清IGF-1水平显著增高(P<0.05)。对照组和观察组患者治疗总有效率分别为65.96%(31/47)、95.74%(45/47),观察组患者治疗总有效率显著高于对照组(χ^2=13.468,P<0.05)。对照组和观察组患者不良反应发生率分别为6.38%(3/47)、10.64%(5/47),2组患者不良反应发生率比较差异无统计学意义(χ^2=0.547,P>0.05)。结论甘露醇联合神经节苷脂注射液治疗急性高血压脑出血,可明显改善患者的临床症状,缩小脑水肿面积、血肿体积,降低血清S100B、NSE水平,升高血清IGF-1水平,有效改善患者的认知功能,提高患者的生活质量。