title: [Insulin application techniques in adult patients with diabetes].
abstract: Treatment of diabetes mellitus with insulin is associated with a large number of subcutaneous injections. Incorrect insulin application technique can lead to complications both local (lipohypertrophy, scars) and systemic (high variability of insulin absorption and action, unexpected hypoglycemia or hyperglycemia, suboptimal overall glucose control). Regarding insulin application, we need to pay particular attention to the risk of intramuscular application and consequent less expectable insulin effect. The risk of accidental intramuscular administration of insulin is reduced when shorter 4 mm insulin pen needles are used. Repeated application of insulin in the same locations may cause changes in the subcutaneous tissue (lipohypertrophy, inflammation). Application sites should be examined during routine checks at diabetes clinics. Patients should also be repeatedly advised to rotate the injection sites as a prevention of lipohypertrophy formation and not to inject any more injections into pathologically changed subcutaneous tissue. At the same time, patients should be advised that their total insulin dose may be decreased, and that they are temporarily at higher risk of hypoglycemia, if they switch injecting from lipohypertrophy changed tissue into healthy tissue.
  
  
  BACKGROUND
  glucose variability - insulin application - lipohypertrophy - needles.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Pelcl
authors.forename: Martin
authors.initials: M
authors.lastname: Prázný
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D006984:Hypertrophy / Q000209:etiology; D007003:Hypoglycemia / Q000139:chemically induced; D007249:Inflammation / Q000209:etiology; D007279:Injections, Subcutaneous / Q000009:adverse effects*; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D040521:Subcutaneous Tissue / Q000473:pathology
chemical_list: D007328:Insulin