Subcutaneous or intramuscular insulin injections

Article Abstract:

Diabetes mellitus is a condition that occurs when the pancreas does not make enough insulin hormone. Insulin is responsible for removing glucose (sugar) from the blood and storing it in muscle tissue and in the liver for future use. Therefore, patients with diabetes have difficulty controlling the amount of sugar in their blood. The standard treatment involves having patients give themselves injections of insulin. In the past, diabetics were taught to make the injection by pinching the skin and inserting the needle into the pinched skin at a 45 degree angle (subcutaneous injection). However, in recent years disposable syringes have become popular for injecting insulin. These new syringes have shorter needles (12.5 millimeters, or mm) and many patients have been told to make the injection by holding the needle at a 90 degree angle to the skin and inserting the full length of the needle into the skin. The goal of this technique is to inject the insulin into the fat layer underneath the skin, but not into the muscle (intramuscular injection). A recent study reported that in 11 of 13 adults the depth of the subcutaneous fat layer in the abdomen was less than 10 mm. This implies that the use of a 12.5 mm needle in the abdomen may result in injecting insulin into the muscle. To investigate this further, the thickness of the subcutaneous layer over the outer arm, thigh, abdomen, calf and buttocks was measured in 32 diabetic children. In the boys, the distance from the surface of the skin to the muscle was less than the length of the needle in all areas measured, except for the buttocks. In most of the girls, the distance from the surface of the skin to the muscle was greater than the length of the needle in all areas, except the calf. Twenty-five of the children reported that they made the injection using the 90 degree angle technique. This means that many boys and some girls who injection insulin at a 90 degree angle and insert the needle all of the way into the skin are likely to be injecting the insulin into muscle instead of into the subcutaneous fat layer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Management, Juvenile diabetes, Injections, Hypodermic, Subcutaneous injections, Diabetes in children

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Insulin, the renin-angiotensin-aldosterone system and blood pressure

Article Abstract:

Insulin has been found to cause an increase in blood pressure through its direct stimulatory effect on sodium retention in the kidney which in turn, induces hypertension. An expected effect of such condition is a depression in the renin-angiotensin-aldosterone (RAA) system. In cases of early non-insulin-dependent diabetes mellitus, however, it has been found that the level of plasma aldosterone, a component of the renin-angiotensin system, does not go down to its expected level. This phenomenon is presumed to be due to the primary effect of hyperinsulinemia.

Research, Hypertension, Renin-angiotensin system

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