Diabetes mellitus is an increasing international health concern with no probability of termination.    The percentage of individuals with type 2 diabetes mellitus (T2DM) is 95% of those with diabetes mellitus in general .    The Middle East and North Africa have the second-highest rate of diabetes with 9.2%;    however, Iraq is one of the 21 countries in the region.    The number of deaths due to diabetes accounts for 10.7% of adult mortalities .    Individuals with T2DM constitute 8.5 - 13.9% of Iraqis .    A noticeable increase was recorded in the percentage of individuals with diabetes (35%) in 2011, compared to that of 2005 (11.9%), among Iranians within the age range of 25 - 70 years .

Obesity or being overweight is the major modifiable risk factor for more than 90% of the patients with T2DM because it exacerbates insulin resistance .    Obese diabetic patients have more visits to hospitals and medical centers due to complications of obesity and diabetes, and the possibility of venipuncture to send laboratory samples or prescribe fluids and medications in this group of patients is high .    For nurses or even other healthcare providers, conducting laboratory diagnostic tests and procedures is considered a paramount portion of patient care that should be performed by following the highest quality of standard guidelines to avoid complications that might result from cannulation and inaccurate findings of laboratory tests .

The literature confirmed that about 90% of patients in a hospital might need intravenous cannulation peripherally to administer medications or replace fluids.    In addition, the literature shows the maximum rate of mistakes in the clinical laboratory that involve sample collection by venipuncture, also known as phlebotomy .    The identification of the vein site is not simple.    Some elements affect the visibility of the patients’ vasculature, such as the difference in the skin character of young children (especially neonates), dehydration, and obesity (9). Due to high subcutaneous fat in obese patients, it is difficult to see veins and have access to blood vessels;    therefore, nurses face numerous problems in terms of time and technique when caring for these patients .    Furthermore, overweight and obesity exacerbate insulin resistance, which leads to the development of complications of diabetes linked to a poor vascular network .

The use of certain devices or techniques, including tourniquet, local heat , ultrasound , and transilluminating devices , will help have better access to the veins of the limbs.    A transilluminating device is one of the technical evolutions which employs near-infrared light-emitting diodes (NIR-LEDs) to show superficial veins with hemoglobin absorbing the light generated and producing a view on the surface of the skin, which has lately been advanced .    Moreover, NIR-LEDs discover the noninvasiveness of the veins for the venipuncture processes, such as blood sample collection and drug preparation, which can be utilized for intravenous administration.    The apparatuses can be utilized in numerous patient care sectors where vascular access operations are carried out and might be utilized for all patients, such as obese or diabetic individuals .

One study showed that BMI, dark skin color, history of unsuccessful cannulation, drug use, and concomitant vascular diseases, such as hypertension and diabetes, have made intravenous cannulation more difficult to succeed due to physiological changes, such as intravascular volume depletion or increased contraction of the sympathetic system for deep veins;    therefore, it is needed to apply some technologies, including local heat and infrared, to increase the success rate;  . 
 
Perry et al. conducted their randomized trial in Texas, USA, in a pediatrics department to examine the effect of the near-infrared illumination on the improvement of the success rate of intravenous cannulation for the first time by increasing the visibility and touch of veins.    The results of the aforementioned study are in line with the findings of the current study.    They proposed that using infrared technology can improve venous detection results .