Recognition of and steps to mitigate anxiety and fear of pain in injectable diabetes treatment

Figures & data

Figure 1 VAS pain scores for 5 mm and 8 mm needles.

Abbreviation: VAS, visual analog scale.

Figure 2 Mean injection site pain intensity (data on file).

Abbreviations: G, gauge; T, tapered.

Figure 3 Mean injection site bruising or bleeding (data on file).

Abbreviations: G, gauge; T, tapered.

Table 1 Strategies for overcoming injection-associated pain

Category	Strategy
Assessment of fear	• Identify past experiences with injections • Identify perceptions about injectable therapy  ◦ Ask open-ended questions  ◦ Use standardized surveys (D-FISQ; Nagai et al^Citation32)
Needle selection	• Select needle designs for syringes and pens that are smaller and thinner or that improve the ease of insertion
Patient education	• Show patients the needles that they will be using for insulin injections and diabetes self-monitoring • Discuss how needles have been designed to improve patient comfort • Instruct on proper injection technique • Allow for supervised injection rehearsals
Behavioral interventions	• Deep breathing • Forceful exhale during injection
Monitoring of therapy	• Assess patient response to prescribed injectable therapies • Inform about and offer alternative regimens to maintain adherence and minimize pain • Provide follow-up education and counseling as needed

Abbreviation: D-FISQ, Diabetes Fear of Injecting and Self-testing Questionnaire.

Table 2 Open-ended questions to assess patient barriers to injectable therapy

• How satisfied are you with your current diabetes therapy?

• How do you think injectable therapy can help with your diabetes?

• Who do you know who has taken injectable therapy and what was their experience?

• What is your past experience with taking injectable medications?

• What is your greatest concern about starting injectable therapy?

• How confident are you that you can take injectable therapy on a regular basis?

• What obstacles do you think will keep you from taking injectable therapy?

• What information/support do you need to have to be willing to take injectable therapy?

NagaiYOhshigeTAraiKComparison between shorter straight and thinner microtapered insulin injection needlesDiabetes Technol Ther2013157550 55523621793

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