An angled insertion technique using 6‐mm needles markedly reduces the risk of intramuscular injections in children and adolescents

Abstract

While intramuscular injections were observed frequently using standard injection protocols, an angled 6-mm needle technique reliably injects into the subcutaneous fat.

The Subcutis Ultrasound Map of Type 1 Diabetic Children Improves the Diagnosis of Local Dystrophies and Insulin Injection Technique

“…The dystrophies can be clinically diagnosed as either hypertrophic, nodular or atrophic. The SC remodelling is a local consequence of some factors such: very frequently injected areas, duration of treatment, inappropriate injecting technique, needle's quality, physicochemical properties of insulins or individual response as suggested by Lo Presti (2012), Hofman (2007Hofman ( , 2010, Bierkebaek (1998), Wallymahmed (2004) and Hildebrandt (1991). Lipodistrophies were noticed when the administration route was either a portable pump or boluses as Rademecker (2007) had found.…”

AMD-OSDI Consensus on Injection Techniques for People with Diabetes Mellitus

“…In the transition from a longer needle to a shorter one, there might be differences in insulin absorption, therefore monitoring blood Subcutaneous tissue thickness varies significantly depending on sex, body mass index, age, ethnicity, diabetes type, morphology of the diabetic individual, as well as, on pressure exerted during injection [8,11,14]. The risk of intramuscular injections depends on that all and has been estimated to be 15.3% with 8 mm, 5.7% with 6 mm and 0.4% with 4 mm needles [14,[26][27][28].…”

“…The risk of intramuscular injections depends on that all and has been estimated to be 15.3% with 8 mm, 5.7% with 6 mm and 0.4% with 4 mm needles [14,[26][27][28].…”

“…Education should also be regularly reinforced and healthcare professionals are expected to perform inspection and palpation interested sites on a regular, systematic basis in all subjects on injection therapy [26,36,48 This article is available from: http://medical-clinical-reviews.imedpub.com/archive.php especially in those facing repeated unexplained hypoglycaemic episodes [11]. Education should not be limited to treatment start, it should rather go on throughout the whole follow-up period with timely reinforcements [63], put special emphasis on the negative effects of getting into the muscle tissue or into altered skin areas.…”

“…In the transition from a longer needle to a shorter one, there might be differences in insulin absorption, therefore monitoring blood Subcutaneous tissue thickness varies significantly depending on sex, body mass index, age, ethnicity, diabetes type, morphology of the diabetic individual, as well as, on pressure exerted during injection [8,11,14]. The risk of intramuscular injections depends on that all and has been estimated to be 15.3% with 8 mm, 5.7% with 6 mm and 0.4% with 4 mm needles [14,[26][27][28].Injection site rotation within large surfaces, needle disposal after each shot and 45° angle pinch technique utilization with needles >6 mm are essential factors to ensure optimal insulin absorption and prevent skin injury [11,15,22,[29][30][31][32][33][34].With the advent of insulin analogues, absorption varies much less both between and within individuals and is therefore more predictable and easier to handle by the patient [30]. However, despite technological advances allowing newer and newer insulin analogue availability, certain absorption/ action affecting factors still remain, such as exercise, counterregulatory hormones, high dosage, incorrectly mixed preparations or even the habit to pull out needles from the skin too early after pen pistons reaching their end stroke positions [29,30].…”