Subcutaneous or Intramuscular Injections of Insulin in Children: Are we injecting where we think we are?

Abstract

OBJECTIVE: This study was designed to assess the insulin injection location in a group of children who had their injection according to their daily practice, thought to lead to subcutaneous injections. RESEARCH DESIGN AND METHODS: The location of the insulin deposit at the injection site was visualized using an ultrasound device. RESULTS: The exact insulin injection location could be localized, and 18 of 59 injections (30.5%) (one injection for each child) were in the intramuscular tissue. Of the children who had intramuscular injection, 15 of 18 were boys. The children who had an intramuscular injection had a significantly lower percentile of BMI (mean ± SE: 47 ± 8 vs. 72 ± 4, P = 0.004), lower distance from skin surface to muscle fascia without a skinfold (5.6 ± 0.6 vs. 11 ± 0.7 mm, P < 0.0001), and a lower distance from skin surface to muscle fascia with a skinfold (8.1 ± 0.9 vs. 15.9 ± 0.8 mm, P < 0.0001) than children who had a subcutaneous insulin injection. CONCLUSIONS: We identified a group of children at risk for intramuscular insulin injections and that may deserve specific injection technique and advice.