Authors (including presenting author) :
Lee Alice, Hui Peggy, Wong Jackson
Affiliation :
Occupational Therapy Department, United Christian Hospital
Introduction :
Background
Diabetes mellitus is an independent risk factor and poses about four times higher risk for thromboembolic stroke than non-diabetic population. Stroke patients with diabetes may have underlying peripheral sensorimotor neuropathy and retinopathy that will affect their ability to perform fine motor activities and activities of daily living involving self-injection of insulin which is important to control blood sugar. Dominant hand dysfunction due to stroke makes it much difficult to self-administration of subcutaneous insulin or ultimately relied on the others. To perform insulin self-injection, patients with diabetes must be able to perform accurately a series of operations necessary for the actual injection. Therefore, a 3D-printed assistive device (i.e. Insulin Injection Pen Adaptor) was invented to allow hemiplegic patients with dominant hand dysfunction to perform, administer their own insulin pen and complete the process of insulin injection independently.
Objectives :
Objectives
To evaluate the use of 3D-printed insulin injection pen adaptor for hemiplegic patients with dominant hand dysfunction.
Methodology :
Methodology
The 3D-printed insulin injection pen adaptor is designed to be used for both Novolin-pen and Lantus. The digital model of the device is created with Computer Aided Design (CAD) software. Different parts of dataset were then 3D-printed with dual extruder and 100-micron layer resolution using Polylactic acid (PLA) filaments. Subsequently, a chemical polishing method is used to polish the printed products by removing the extension support and acquiring a smooth surface. Refinements were made to improve the fitness and function.
Result & Outcome :
Result
A total of 8 stroke patients with difficulty in insulin self-injection due to hemiplegic hand function deficit (6 patients using Novolin pen and 2 patients using Lantus) were enrolled in the pilot project. Prior to the using of device, all participants perform the insulin injection with their own adapted method, such as holding the insulin pen with their mouth/ between thigh when attaching/removing the needle. Besides, they encountered great difficulty in turning the dial to the correct dosage and need helper’s assistance. With the using of 3D-printed insulin pen adaptor, all participants were able to use the insulin pen independently. They were able to dial the dose and inject the medication independently using only one hand. Patient satisfaction survey results indicated that they were overall very satisfied (over 95%) with the device, regarding both the application and the effectiveness.
Conclusion
Subcutaneous insulin administration is an activity of daily living that should be addressed in the rehabilitation of hemiplegic patients with diabetes. With the availability of 3D-printed insulin injection pen adaptor, they could administer self-insulin injection in a safe and independent way. Further investigations on the clinical efficacy and effectiveness are warranted in future research.
