Insulin

Problems with injections

• Local hypersensitivity reactions to insulin injections are uncommon but when they do occur, formal identification of the insulin (or more rarely preservative) responsible may be possible with help from the manufacturer, or a trial of an alternative insulin preparation may solve the problem
• Lipohypertrophy with the accumulation of fat and fibrous tissue in lumps underneath the skin is common in children
• Lipoatrophy is now uncommon since the introduction of highly purified insulins
• Painful injections are a common problem in children. Check angle and depth of injection to ensure injections are not being given IM
• Leakage of insulin is common and cannot be avoided. Encourage slower withdrawal of the needle from the skin, stretching of the skin after the needle is withdrawn, or pressure with a clean finger over the injection site
• Bruising and bleeding are more common after IM injection or tight squeezing of the skin
• Bubbles in insulin should be removed whenever possible. If the bubble is not big enough to alter the dose of insulin it should not cause problems