Effect of re-coaching on self-injection of insulin in older diabetic patients - Impact of cognitive impairment

Abstract

Aims: We investigated the effect of re-coaching on self-injection of insulin and impact of cognitive function in 100 older diabetic patients.

Methods: We examined patients on a variety of skills and knowledge regarding self-injection of insulin and evaluated the effect of re-coaching the patients after 3months and 4years. We also investigated the influence of cognitive impairment (CI) on coaching.

Results: Skills scores for self-injection of insulin and HbA1c improved significantly 3months after re-coaching. In 51 patients followed-up for 4years, skills scores were maintained during the 4years, while knowledge scores improved after 3months but then returned to the baseline level. In the group of patients with CI as determined by the Mini-Mental Status Examination, skills scores were similar to those in the group without CI, while knowledge scores were significantly lower as compared with those in the group without CI at any time point. Skills scores were maintained during the 4years regardless of CI.

Conclusion: The present study showed that re-coaching in skills for self-injection of insulin was effective in improving and maintaining insulin treatment in older diabetic patients, even if patients had CI.

Keywords: Cognitive impairment; Diabetes mellitus; Insulin treatment; Self-injection.