People using multiple daily injections
of insulin often develop hypertrophy. Many people are not aware of
hypertrophy. This is the enlargement of the areas that has received
too many insulin injections. This enlargement is often the result of
scar tissue, which causes insulin to pool in this area, and this can
increase the enlargement and the scar tissue can trap the insulin and
prevent it from getting into the blood stream.
This means that they often have serious
blood glucose issues and are difficult to manage. To avoid this
problem, many people are not taught about the areas that are useful
and can be used to inject insulin. See the diagram below from BD Diabetes.
Rotating among these sites may reduce
the risk of lypodystrophy, lumps of fat that develop under the skin
from injecting in the same spot repeatedly. Lypodystrophy is not
found in any medical dictionary I have, but the BD website uses the
term.
For most of us, the stomach area works
the best and the area on the arms is second best. The biggest
problem many people using insulin is injecting the fast acting
insulin in an area too close the long acting insulin. If you want an
episode of hypoglycemia (low blood glucose below 70 mg/dl), this is
how you do it. I don't recommend this, as it is dangerous and
unsafe. This is the reason I use a different area for long acting
insulin than I am using for fast acting insulin.
Please understand the hypertrophy is
serious and can upset the best management plan. Do not inject
insulin in the same spot day after day to prevent this and rotate in
the selected areas. I use the different areas on a regular basis and
after twelve years and four months, I have a few areas of
hypertrophy. I also realize that at my age, the areas of hypertrophy
may not heal as quickly so I have to be very careful.
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