Predicting the ability of elderly diabetes patients to acquire the insulin self-injection technique based on the number of animal names recalled.

Aims/introduction: To our knowledge, no studies have reported that cognitive tests can be used to evaluate whether or not patients can acquire the insulin self-injection technique. We investigated whether or not the number of animal names recalled in 1 min by elderly diabetes patients could be used as a predictor of the patients' ability to acquire the insulin self-injection technique within 1 week.

Materials And Methods: We enrolled 57 inpatients with type 2 diabetes aged >60 years who were starting insulin therapy. We carried out the Mini-Mental State Examination and verbal fluency tests, which included recalling animal names and common nouns starting with the letters 'a,' 'ka' and 'shi' (Japanese letters). We used 12 checkpoints for insulin self-injection to judge the patients' levels of acquisition of the technique. The most predictive cognitive test was determined by multivariate logistic regression analysis.

Results: In the present study, multivariate logistic analysis showed that the number of animal names recalled was the most reliable predictor of the ability to acquire the insulin self-injection technique within 1 week. A figure of 11 animal names predicted a successful acquisition, with a sensitivity of 73% and a specificity of 91% being observed (area under the curve 0.87, 95% confidence interval 0.76-0.97, P < 0.01).

Conclusions: The number of animal names recalled in 1 min was the most useful indicator of the ability of elderly diabetes patients to learn to manage insulin self-injection therapy within 1 week. The cut-off value was 11 animal names.