CASE REPORT - TISSUE DYSTROPHIES AS A RESULT OF SUBCUTANEOUS INSULIN INJECTIONS CLINICAL AND ULTRASOUND ASPECTS.

Abstract

Subcutis tissue pathology induced by the injected drugs, including insulins has not yet a large US evidence. Insulin treatment should be administered into undamaged skin and into subcutaneous fat layers in order to maintain its normal absorption. Systematic rotation of injection sites within the same anatomic area, some individualized injection devices and a specific educational program help to avoid dystrophic lesions. The thickness of the subcutis layer depends on the body mass index, fat distribution and anatomical areas. Needle lengths depend on the subcutis thickness of a given area. Inappropriate needle length repeatedly used or a vicious injection technique are well-known tissue offenders.

A repeated trauma adds mechanical disruption, a sterile or infectious inflammation by itself. Because of this fatty reconstruction, un unpredictable insulin absorption is reached. A carefully and periodically inspection of insulin injection sites should be made, in order to diagnose insulin injected dystrophies. Ultrasonographic appearances must be added to the clinical ones. The insulin treated patients, irrespective of their age, cannot afford to damage many areas during their life-time injection treatment. Due to this fact an US map of the abnormal and available areas should be periodically made.