Table 2: Questionnaire for assessing safety of insulin delivery device.
Safety assessment questions | |||
---|---|---|---|
S No | Question | Options | Score* |
1 | How painful is the process of injecting your insulin? | Acceptable pain Bearable pain Unbearable pain |
1 2 3 |
2 | How many bruising episodes at injection sites have you had in the last 5 days? | None 1 episode >1 episode |
1 2 3 |
3 | How many episodes of high sugars (your perception) have you noticed in the last one week? | None 1 episode >1 episode |
1 2 3 |
4 | How many episodes of low sugars (your perception) have you noticed in the last one week? | None 1 episode >1 episode |
1 2 3 |
5 | How many times have your broken your insulin vial/cartridge in the past one year? | None 1 episode >1 episode |
1 2 3 |
*Scoring as per response. Minimum score of 5, maximum score of 15. Lower score indicates safer device and a higher score denotes a more unsafe device.