Skin-related adverse events and their determinants among Diabetic patients on insulin therapy.

BackgroundGlobally, more than 530 million people live with diabetes mellitus (DM), and the burden continues to rise. Insulin remains the cornerstone of DM management worldwide. However, literature indicates that insulin users are at risk of developing abscesses and scar formation at injection sites. These complications may compromise adherence to therapy, thereby affecting the intended therapeutic outcomes. This study aimed to assess the prevalence of abscesses and scar formation at injection sites and their determinants among diabetic patients on insulin therapy in Dar es Salaam, Tanzania. MethodsA hospital-based analytical cross-sectional study was conducted between February and May 2024. A total of 428 patients with DM on insulin therapy were enrolled from four selected hospitals in Dar es Salaam. A validated case report form (CRF) was used to collect socio-demographic characteristics and clinical data related to abscess and scar formation following insulin therapy. Data were analyzed using Stata version 15.0 software, with findings summarized as frequencies and percentages. Determinants of abscess and scar formation were assessed using modified Poisson regression, and a p-value of <0.05 was considered statistically significant. ResultsOut of 428 participants, 191 (44.6%) were aged over 45 years, 233 (54.4%) were female, and 185 (43.2%) had a primary education level. The prevalence of abscesses and scar formation was 95 (22.2%) and 200 (46.7%), respectively. Determinants of abscess formation included improper injection technique (aPR = 1.11; 95% CI: 1.02-1.21, p = 0.009), improper injection site rotation (aPR = 2.7; 95% CI: 1.13-6.45, p = 0.025), and the use of an insulin pen (aPR = 0.13; 95% CI: 0.04-0.48, p = 0.002). For scar formation, determinants included improper injection site rotation (aPR = 1.63; 95% CI: 1.03-2.32, p = 0.037), uncontrolled blood glucose levels (aPR = 1.69; 95% CI: 1.01-2.84, p = 0.049), and the use of insulin and syringes obtained from community drug outlets (aPR = 2.51; 95% CI: 1.22-1.98, p = 0.035). ConclusionThe study identified a significant burden of abscess and scar formation among DM patients on insulin therapy. Key determinants included improper injection techniques, inadequate rotation of injection sites, and uncontrolled blood glucose levels. Regular training for DM patients on proper insulin injection practices is essential to minimize these complications.