The Pharmaceutical Journal
Vol 270 No 7231 p50
11 January 2003

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Letters to the Editor

Insulin labelling

Do patients understand "subcutaneous"?

From Mrs I. Gummerson, MRPharmS

I read with interest the letters from Neil Caldwell (PJ, 23 November 2002, p742) and Gavin Miller (PJ, 14 December 2002 , p845), about the labelling of insulin. I agree that insulin requirements for individual patients often change, and that this poses a dilemma when a pharmacist wishes to label usefully. I am glad that Mr Miller consulted the multidisciplinary team in his deliberations about labelling, and I would agree with his comments, except for the use of the word "subcutaneous".

I wonder whether the most important person of the diabetes team, the patient, had also been consulted. I telephoned a colleague at Diabetes UK who, after a discussion with others, said that "subcutaneous" would not be understood by most patients, but she said they were struggling for a user-friendly alternative. In the end "inject under the skin, but not into the muscle" was put forward.

So, if Mr Miller and Mr Caldwell, who are both from secondary care, were talking about labelling only for other professionals, eg, nurses, there is no problem — unless the patient is given his ward insulin supply to take home on discharge.

I work in community and am part of the second wave of the medicines management collaborative, with a local general practitioner. One of the targets of the GP practice is to increase the number of medicines that reach the patient with full directions, as opposed to just "as directed". We have tackled warfarin labels, but as yet have not tackled insulin labelling, and I therefore welcome the discussion opened by Mr Caldwell, and if we can get a consensus on an alternative to "subcutaneous", then I shall happily recommend Mr Miller's suggestion to my GP colleague.

Irene Gummerson
Wakefield, West Yorkshire

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