EVALUATION DE LA PRATIQUE DE L’INSULINOTHERAPIE PAR LES SUJETS DIABETIQUES AU CENTRE DU DIABETE MARC SANKALE

Introduction: Insulin therapy is a substitute and referencetherapy for type 1 diabetes (T1D), unbalanced gestationaldiabetes and certain circumstances of type 2 diabetes(T2D). Its practice requires good therapeutic education,which guarantees a reduction in complications. Theobjective was to evaluate the practice of insulin therapy indiabetics followed at the Marc Sankalé Antidiabetic Centerin Dakar.Methods: This was an observational, descriptive andanalytical study conducted from April 1 to September 31,2021 and involving 202 diabetic patients on insulin therapy.Results: The mean age of the patients was 39.04 ± 14 yearsand the sex ratio 0.28. The socioeconomic standard of livingwas considered low in 67% and 41% had no schooling.These were 39% T2D, 36% T1D and 25% gestationaldiabetes. The diabetes had a duration < 5 years in 65%and 94% of the patients had benefited from at least 02education sessions. Mean blood sugar was 1.93 ± 0.9 g/land HbA1c was >7.5% in 66% of cases. In our series, 47.5%had previously presented a hyperglycemia complication,29.2% hypoglycemia. Decreased visual acuity andneuropathy were observed respectively in 37.6% and 36.6%of cases. The duration of insulin therapy was <12 monthsin 60% and 54% of patients used the vial against 44% forthe pre-filled pen. In practice, 69% kept the insulin cool,only 8% purged the syringe or pen, 98% reused the needleor syringe and 91% of patients shook the insulin beforeuse. A skin fold was performed before injection by 17% ofpatients, 76% regularly changed injection site. Only 7% ofpatients were assisted by a third party for the injection. Onglycemic self-monitoring, 24% checked their glycemiabefore the administration of insulin and only 23% had ablood glucose meter. Hypoglycaemia was found in 30% ofcases.Conclusion: despite a precarious environment, the practiceof insulin therapy by diabetics at the Marc Sankalé Centerseems satisfactory. The challenges lie in providing patientswith tools that make it easier for them to comply with hygienerules and blood glucose monitoring.Keywords : Diabetes, Insulinothérapie, Center MarcSankalé, Dakar1