It is a rather disturbing insulin injection side effect due to the resulting blemishes, for which no solutions have been identified as yet. Unfortunately, in terms of both patient and healthcare provider perspectives, injection-related problems negatively affect the overall number of shots that patients with diabetes are willing to take, so that in some studies half of the patients reported mentioning such problems to their healthcare providers without getting any solution against the associated pain and bruising [ 6 , 16 , 17 ].
Concerning that, site-related adverse events, including pain, redness, bleeding, and, especially, bruising, are significant barriers to patient adherence to multiple daily injection regimens. To fill this gap, during the last few years, an interesting exchange of experiences started among patients through various networks, including the American Diabetes Association Community first [ 29 ].
Such forums enabled patients to propose several attractive solutions themselves, including a sufficiently long injection time, thin and short needles, and a careful injection site rotation protocol.
However, specific investigations are still warranted to assess the reasons behind the aforementioned injection complications and to identify scientifically sound solutions aimed to improve patient adherence to insulin therapy. Interestingly, we noticed that many patients do not handle pens correctly while injecting insulin, by often using both hands or failing to complete the injection fully.
They most often press the pen onto the skin too hard so that the needle-cone injuries the site Fig. This occurred primarily in our older patients having hand joint problems or feeling insecure for fear of the injection.
Such anecdotal observations need verification, through dedicated studies. Panel a shows stronger pen pressure into the skin deep skin hollow at the time of injection than in b. The association between BR and high HbA1c levels, missed injection site rotation, and long-standing insulin treatment likely reflects inadequate patient education. The significantly lower number of patients with BR than with LH who reported insulin treatment longer than 9 years could depend on the fact that the injury behind BR, despite being caused by repeated micro-traumas like LH, may be an early step of LH formation which does not cause tissue hypertrophy and so does not cause insulin pharmacokinetic alterations.
Such a hypothesis deserves extensive investigation. A major limitation of our study is that clinical explanations for BR are largely hypothetical. However, the newest and most relevant finding is that BR does not influence hypo rate and GV significantly, opposite to what is seen with LH.
This study was conducted in a specialized setting and using strict methodology to confirm that missing site rotation and needle reuse are significant risk factors for LH.
The close relationship between LH and poor metabolic control could suggest that all patients with clear-cut difficulties in achieving optimal control should be checked systematically for LH presence at all insulin injection sites. The same applies to those who experience frequent unexplained hypos or large GV. An evaluation of patient preference for an alternative insulin delivery system compared to standard vial and syringe.
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Why are so huge differences reported in the occurrence rate of skin lipohypertrophy? Does it depend on method defects or on lack of interest? Diabetes Metab Syndr. Factors hindering correct identification of unapparent lipohypertrophy.
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Diabetes Technol Ther. Lipohypertrophy in elderly insulin-treated patients with type 2 diabetes. Clin Ther. Indian J Endocrinol Metab. Chowdhury TA, Escudier V. Integrated Diabetes Services IDS provides detailed advice and coaching on diabetes management from certified diabetes educators and dieticians.
Q: Is it common to get bruises at the site of injection? What can you do about that? A: There are many reasons that an injection site might develop a bruise. Try some of these techniques to decrease the chances of bruising:.
Have a Question? In addition to working with your primary healthcare provider, you may want to work with a certified diabetes educator. Certified diabetes educators are specifically trained in many aspects of managing diabetes and are a great source of education and information. Injecting into the wrong spot Injections should ideally go directly into fat tissue, not the muscle underneath. In areas with less fat, the injection will reach the muscle, which can be quite painful and also cause a bruise to form.
Needles that are too long may also cause this. Not injecting at the right angle Lift a fold of skin and inject the medication at a degree angle, not at a slanted angle.
A straight on approach will allow you to puncture the skin more easily and decrease the chances of bruising. Low levels of the male hormone testosterone affect muscle mass, bone density, and more. Learn if testosterone injections work and if they're right for…. The risk factors for type 2 diabetes are complex and range from genetic to environmental to lifestyle choices.
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Repeated insulin injections in the same location can cause fat and scar tissue to accumulate. Symptoms of lipohypertrophy.
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