For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
5
views
73
references
 Top references
cited by
14
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      112
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The Injection Technique Factor: What You Don’t Know or Teach Can Make a Difference

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          IN BRIEF To be consistently effective, insulin must be delivered into subcutaneous tissue. If insulin is delivered intramuscularly, its uptake and action become variably faster, leading to suboptimal, inconsistent glucose control. The best strategy to avoid intramuscular injection is to use the shortest needles available. Injection sites should be rotated systematically to prevent lipohypertrophy, which also substantially affects insulin uptake and action. New evidence-based insulin delivery recommendations are available, and awareness of them should lead to more effective use of insulin therapy, improved clinical outcomes, and considerable cost savings.

          Related collections

          Most cited references73

          • Record: found
          • Abstract: found
          • Article: not found

          Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes.

          M. Blanco, M. T. Hernández Aguilar, K W Strauss … (2013)
          Our objective was to assess the frequency of lipohypertrophy (LH) and its relationship to site rotation, needle reuse, glucose variability, hypoglycaemia and use of insulin.
          Article 0 comments Cited 102 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections: implications for needle length recommendations.

            Patrick A. Gibney, Matthew Hirsch, K Byron … (2010)
            During subcutaneous insulin therapy, inadvertent intramuscular (IM) injections may increase pain and/or adversely affect glucose control. The most appropriate needle length for patients depends on skin thickness (ST) and the distance to muscle fascia. ST and subcutaneous adipose layer thickness (SCT) were measured in adults with diabetes. A total of 388 US adults with diabetes (in three BMI subgroups: or=30 kg/m(2)) with diverse demographic features were evaluated. Each subject had ultrasound measurements of ST and SCT at four injection sites. Subjects had BMI 19.4-64.5 kg/m(2), age 18-85 years; 40% Caucasian, 25% Asian, 16% Black, 14% Hispanic; 28% type 1 diabetes. Mean ST (+/-95% CI) was: arm 2.2 mm (2.2, 2.3), thigh 1.9 mm (1.8, 1.9), abdomen 2.2 mm (2.1, 2.2) and buttocks 2.4 mm (2.4, 2.5). Multivariate analyses showed body site, gender, BMI, and race are statistically significant factors for ST but effects were small. Thigh ST was or=8 mm, inserted perpendicularly, may frequently enter muscle in limbs of males and those with BMI <25 kg/m(2). With 90 degrees insertion, needles 4-5 mm enter the subcutaneous tissue with minimal risk of IM injection in virtually all adults. These data will assist recommending appropriate length needles for subcutaneous insulin injections in adults.
            Article 0 comments Cited 65 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Results and analysis of the 2008-2009 Insulin Injection Technique Questionnaire survey.

              Anabella R M Gaspar, Pierre Sauvanet, J Liersch … (2010)
              The efficacy of injection therapy in diabetes depends on correct injection technique and, to provide patients with guidance in this area, we must understand how they currently inject. From September 2008 to June 2009, 4352 insulin-injecting Type 1 and Type 2 diabetic patients from 171 centers in 16 countries were surveyed regarding their injection practices. Overall, 3.6% of patients use the 12.7-mm needle, 1.8% use the 12-mm needle, 1.6% use the 10-mm needle, 48.6% use the 8-mm needle, 15.8% use the 6-mm needle, and 21.6% use the 5-mm needle; 7% of patients do not know what length of needle they use. Twenty-one percent of patients admitted injecting into the same site for an entire day, or even a few days, a practice associated with lipohypertrophy. Approximately 50% of patients have or have had symptoms suggestive of lipohypertrophy. Abdominal lipohypertrophy seems to be more frequent in those using the two smaller injection size areas, and less frequent in those using larger areas. Nearly 3% of patients reported always injecting into lipohypertrophic lesions and 26% inject into them sometimes. Of the 65% of patients using cloudy insulins (e.g. NPH), 35% do not remix it before use. It is clear from the latest survey that we have improved in certain areas, but that, in others, we have either not moved at all or our efforts have not yielded the results we expected. The results of the present survey are available online on a country-by-country and question-by-question basis at http://www.titan-workshop.org. © 2010 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.
              Article 0 comments Cited 52 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Diabetes
                Journal ID (iso-abbrev): Clin Diabetes
                Journal ID (hwp): diaclin
                Journal ID (publisher-id): Clinical Diabetes
                Title: Clinical Diabetes : A Publication of the American Diabetes Association
                Publisher: American Diabetes Association
                ISSN (Print): 0891-8929
                ISSN (Electronic): 1945-4953
                Publication date (Print): July 2019
                Volume: 37
                Issue: 3
                Pages: 227-233
                Affiliations
                [1 ]BD Diabetes Care, Franklin Lakes, NJ
                [2 ]BD Diabetes Care, Erembodegem, Belgium
                Author notes
                Corresponding author: Kenneth W. Strauss, kenneth.strauss@ 123456bd.com
                Article
                Publisher ID: 227
                DOI: 10.2337/cd18-0076
                PMC ID: 6640874
                PubMed ID: 31371853
                SO-VID: 9a6440d4-418d-4b64-9036-f52a7dcdaccc
                Copyright © © 2018 by the American Diabetes Association.
                License:

                Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0 for details.

                History
                Page count
                Pages: 7
                Categories
                Subject: Feature Articles

                Data availability:

                Comments

                Comment on this article

                scite_

                Similar content112

                See all similar

                Cited by14

                See all cited by

                Most referenced authors606

                See all reference authors