Free injection technique education could lead to ‘cost saving and better health outcomes’

Diabetes Times | 17 March 2021 | Free injection technique education could lead to ‘cost saving and better health outcomes’

A new article in the Diabetes Times explains how a GP from Darlington is urging healthcare professionals to take up free injection technique education because understanding the subject leads to ‘efficiency, cost saving and good patient health’.

A series of webinars which start tonight (18 March 2021) will focus on providing healthcare professionals with working examples and real-life, in-practice patient case studies on best practice injection techniques.

In my experience injection technique is something which is often forgotten by people with the condition and in a lot of cases it’s also something that’s not fully understood by healthcare professionals.”

One of the main conditions that improper injection techniques can cause is lipohypertrophy.

: “We are creatures of habit so those who have not been educated about rotating their injection sites, and to use a fresh needle each time, will start to develop these lumpy bits on their skin (lipohypertrophy). These areas will require more insulin to be injected as the body takes longer to absorb it. The danger comes from when people start injecting into other healthy areas, and use the same dosage which can cause low blood sugar.

Dr Patrick Holmes, a GP from St George’s Medical Practice, Darlington

Further details about the webinar are available from The Diabetes Times

Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial

Davies, M., STEP 2 Study Group, et al | 2021 | Semaglutide 2· 4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial |The Lancet | DOI: https://doi.org/10.1016/S0140-6736(21)00213-0

In this trial adults with overweight or obesity, and type 2 diabetes, semaglutide 2·4 mg once a week achieved a superior and clinically meaningful decrease in bodyweight compared with placebo

Summary
Background

This trial assessed the efficacy and safety of the GLP-1 analogue once a week subcutaneous semaglutide 2·4 mg versus semaglutide 1·0 mg (the dose approved for diabetes treatment) and placebo for weight management in adults with overweight or obesity, and type 2 diabetes.

Methods

This double-blind, double-dummy, phase 3, superiority study enrolled adults with a body-mass index of at least 27 kg/m 2 and glycated haemoglobin 7–10% (53–86 mmol/mol) who had been diagnosed with type 2 diabetes at least 180 days before screening. Patients were recruited from 149 outpatient clinics in 12 countries across Europe, North America, South America, the Middle East, South Africa, and Asia. Patients were randomly allocated (1:1:1) via an interactive web-response system and stratified by background glucose-lowering medication and glycated haemoglobin, to subcutaneous injection of semaglutide 2·4 mg, or semaglutide 1·0 mg, or visually matching placebo, once a week for 68 weeks, plus a lifestyle intervention. Patients, investigators, and those assessing outcomes were masked to group assignment. Coprimary endpoints were percentage change in bodyweight and achievement of weight reduction of at least 5% at 68 weeks for semaglutide 2·4 mg versus placebo, assessed by intention to treat. Safety was assessed in all patients who received at least one dose of study drug. This study is registered with ClinicalTrials.govNCT03552757 and is closed to new participants.

Findings

From June 4 to Nov 14, 2018, 1595 patients were screened, of whom 1210 were randomly assigned to semaglutide 2·4 mg (n equal to 404), semaglutide 1·0 mg (n equal to 403), or placebo (n equal to 403) and included in the intention-to-treat analysis. Estimated change in mean bodyweight from baseline to week 68 was −9·6% (SE 0·4) with semaglutide 2·4 mg vs −3·4% (0·4) with placebo. Estimated treatment difference for semaglutide 2·4 mg versus placebo was −6·2 percentage points. At week 68, more patients on semaglutide 2·4 mg than on placebo achieved weight reductions of at least 5 per cent. Adverse events were more frequent with semaglutide 2·4 mg and 1·0 mg than with placebo. Gastrointestinal adverse events, which were mostly mild to moderate, were reported in 256 of 403 patients with semaglutide 2·4 mg, 231 of 402 with semaglutide 1·0 mg, and 138 of 402 with placebo.

Interpretation

In adults with overweight or obesity, and type 2 diabetes, semaglutide 2·4 mg once a week achieved a superior and clinically meaningful decrease in bodyweight compared with placebo.

Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial