What Patients Who Inject Insulin Need To Know

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When injecting insulin, there are many things you have to manage to make sure your blood sugars, are controlled. Aside from your actual insulin plan, you must monitor your blood sugars to make sure that they aren’t too low and that your plan is helping you reach your blood sugar goal. Often times not much thought goes into the importance of how and where the insulin is taken.

It is recommended that insulin be injected into the fatty layer where it is consistently absorbed. The time it takes for insulin to be absorbed and begin working in your body is important to make sure that the blood sugar is controlled. The absorption won’t be what is expected when it is injected into the muscle and unhealthy injection sites. Unhealthy injection sites include those with bruising, scars, and lipohypertophy.

Lipohypertrophy, or lipo for short, is when the fatty layer at the injection site grows too much leaving lumps that can be seen or in many cases just felt under the skin.1 If lipo forms, you must avoid injecting into it. Less insulin may be absorbed when injected into lipo which can cause high blood sugars.2 Also when you move from injecting into the lipo to healthy sites, more insulin is absorbed through the healthy site compared to sites with lipo which could lead to low blood sugars. This constant movement between high blood sugars to low blood sugars can make it difficult to reach your average blood glucose goal (A1c).

Improper site rotation and using needles more than once have been shown to increase the risk of forming lipo. Using the same needle multiple times increases the risk of forming lipo.3 They should only be used once with each injection. Practicing proper site rotation and avoiding the reuse of needles are ways you can prevent lipo and the problems they cause with blood sugar control.
What you can do to prevent lipo:

  • Select one of the injection sites below:
    • Stomach
    • Thigh
    • Arm
    • Buttocks
  • Rotate within your injection site
    • It is suggested to inject within a site for a few days before moving to a new site
    • Each injection should be at least a finger width apart
  • Use a new needle with each injection

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  1. Richardson T, Kerr D. Skin related complications of insulin therapy: Epidemiology and emerging management strategies. Am J Clin Dermatol 2003;4:661-7.
  2. Johansson UB, Amberg S, Hannerz L, et al. Impaired absorption of insulin aspart from lipohypertrophic injection sites. Diabetes Care. 2005;28:2025-2027.
  3. Blanco M, Hernandez MT, et al. Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes. Diabetes Metab. 2013;39(5):445-53.

 

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