FIT South Africa Recommendations

The results of an international survey [1,2] led to an increasing awareness of problems associated with inadequate injection techniques. Since the publication of the International FIT guidelines, it was felt that there was a great opportunity for recommendations that best suit local needs in South Africa.

The South African FIT initiative has been developed to assist with ongoing injection technique concerns. Following the precedence set by the United Kingdom FIT®, as well as other international injection technique guidelines [3,4,5,6,7], this document has been created to promote best practice in injection technique for everyone involved in diabetes care. [5,7,8]

A meeting of leading experts in diabetes education was held to identify areas of priority in injection technique.

The three leading priorities were:

1. To ensure subcutaneous (SC) injection and avoid intramuscular (IM) injection.

2. To ensure healthy injection sites.

3. To provide clear and concise instruction for healthcare professionals and patients regarding injection techniques.

Using these priorities as a framework, this best practice document was developed and reviewed by the South African FIT board. It has also been reviewed by the diabetes education experts and, where evidence did not exist, expert opinion has guided the recommendation.

A South African injection practice survey will be conducted, following the publication of the first recommendations, and analysis of this data will guide future recommendations.

NEED FOR SOUTH AFRICAN GUIDELINES:

For many South Africans living with diabetes who are dependent on insulin for glucose control, appropriate injection technique is an important part of diabetes management.

While insulin is prescribed, the appropriate administration device and needles are frequently not specified on the prescription. The choice of device and needles (needle length and gauge) are often left to the discretion of the pharmacist.

Appropriate injection technique recommendations are crucial for the success of insulin therapy. These recommendations will:

• provide a framework for healthcare professionals

• help guide rational management decisions, and

• prevent the use of outdated or dangerous practice

Guidelines giving evidence based recommendations are also an important element in assisting the National Department of Health and healthcare funders to provide and fund diabetes care at an acceptable level . A national guideline removes ignorance and holds all stakeholders accountable.

This document will be distributed to all healthcare professionals involved in injection therapy for diabetes.

The development of FIT and the subsequent South African recommendations for injection technique have been supported by Becton Dickinson (BD) South Africa and endorsed by pharmaceutical companies whose therapies include subcutaneous injections of insulin and GLP-1 receptor agonists.