Different sites of insulin injection- good or bad?
Hi, my friend's father is a 54-year-old man with type 2 diabetes who has had fluctuating glucose readings over the past 3 months, with some readings greater than 200 mg/ dL and others below 70 mg/dL. His most recent glycated hemoglobin level was elevated at 8.0%, in contrast to his previous value of 6.9%. He says he has had consistent meal intake, and has been on the same doses of his prandial and basal insulin during this time period. He keeps a diary of his daily meals and glucose readings, and it is apparent that he performs his blood glucose testing consistently in regard to meals, and at approximately the same times each day. For his diabetes management, he is taking metformin 1000 mg twice a day, insulin glargine 30 U at bedtime, and insulin as part 10 U 3 times a day (15 minutes before meals). He also reveals that he injects his insulin somewhere different with each administration, saying he thought he was “supposed to rotate injection sites.” Can anyone
suggest is it good or bad?
@vishwas Different sites of injection have different rates of insulin absorption and subsequent effects on glucose levels. Therefore, the American Diabetes Association position statement on insulin administration, discourages rotating injections among different sites with each injection. Insulin is absorbed quickest from the abdomen, followed by the arms, thighs, and buttocks. The pharmacist should suggest so that he keeps his injection site consistent for each type of insulin he is injecting. For example, his prandial insulin (aspart) can be injected into his abdomen, whereas his basal insulin (glargine) can be injected into an area with slower absorption (eg, his thigh). For each type of insulin, the pharmacist can recommend to rotate injection sites within the general area, with sites separated by 1 inch or more to prevent lipo-hypertrophy, which could impair insulin absorption. In addition, verify that he is injecting insulin subcutaneously, and inform him that changing an injection site can increase the rate of insulin absorption.