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Question:

From Minneapolis, Minnesota, USA:

I am a 29 year old female who has had type 1 diabetes for 27 years. I have just recently switched to a three shot per day regimen, and I was told to only use my abdomen for injections. I am noticing three things:

  1. Stinging pain that lasts for a few minutes after I inject Ultralente (it doesn't seem to happen when I inject only Humalog at breakfast and lunch).
  2. Lumps on my belly
  3. Needle phobia

I have had lipohypertrophy in other areas (arms, legs, and low on my abdomen), but this is different. It hurts, and has come on very suddenly, despite the fact that I rotate my sites (all over my abdomen) with every injection. I'd really like to go back to using all my sites, but both my endocrinologist and my Certified Diabetes Educator say that the belly gives the most consistent absorption, which I have found to be true. I don't want a lumpy belly!

The needle phobia is very real. I know you people think this doesn't hurt, but you're wrong. The vast majority of you only inject saline, which should never hurt. The shots and finger sticks do hurt -- especially when you're sticking yourself 10 or 12 times per day, and I'm becoming phobic. If I was six, and my mom was still giving my shots, I'd believe using ice cubes and hugs were a cure, but I'm finding that I'm not really affected by either of those when I'm doing them myself. Any ideas?

Answer:

You have had a long journey with diabetes and are, indeed, the expert on your body and how injections really feel. You have mentioned all that I can think of to teach to my patients. The only thing you didn't mention is if you use alcohol wipes to clean the skin before injections. I have heard from many patients that this does cause burning and alcohol is really unnecessary if your skin is clean.

As for your needle phobia, you might want to consider using an insulin pump which would give you a much smoother insulin curve and would only require changing the site every 48 hours or so. Maybe your educator can introduce you to people who have had the same experiences as you and talk to them about the pros and cons of pump therapy. The other alternative would be a needleless injector system which are available from at least two companies. The insulin enters the skin with high powered air injection and is mostly painless and helpful to many. You may see a difference in absorption of your insulin from this approach, but your frequent blood testing will always show you the way.

I'm sorry that I don't have any magic to offer. I hope that you can get with others who are on the same journey.

KS

[Editor's comment: See: Is pumping for you?, Jet Injectors, Jet Injector Fact Sheet , GentleJet, and INJEXT30.

You might also try using an Inject-Ease® device, or EMLA Cream. SS]

DTQ-20010407201416
Original posting 7 May 2001
Posted to Blood Tests and Insulin Injections

  
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Last Updated: Tuesday April 06, 2010 15:09:22
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