Diabetes Insulin Injection Problems
Common Health Issues

Diabetes Insulin Injection Problems

Insulin is a hormone that the body produces to do many jobs. One of its most important jobs is to act as a key to let glucose into cells, where it is used for energy. Without glucose, cells die and the body cannot survive. If you have diabetes, insulin somehow can’t do its job. If you have type 1 diabetes, your body doesn’t make the insulin it needs and you will have to give yourself insulin. If you have type 2 diabetes, your body probably makes insulin, but it may not make enough or it may not respond to insulin the way it should. 


Even though your body makes insulin, you may find that you have to take extra insulin to keep your diabetes under control. Most of the problems with insulin involve delivery. Getting it to the right place at the right time in the amount needed is not always an easy task.


Diabetes Injection Site Problems

Several types of problems can occur at injection sites. Lipoatrophy results from a loss of fat at the injection site and appears as dents in the skin. Hypertrophy is caused by an overgrowth of fat cells and gives the skin a lumpy appearance. The key to overcoming these types of problems is to rotate the injection site. In addition to these two common skin problems, some people experience burning, itching or a rash at the injection site. This may be due to a local insulin allergy that is not helped by rotating the injection site.


Diabetes Injection Site Symptoms

If you notice indentations or dents in the skin near your injection site, then you may have lipoatrophy. This condition is thought to be caused by an immune reaction to insulin that results in a loss of fat under the skin where you inject insulin.


If you notice lumps in the skin around your injection site, then you may have hypertrophy, also known as lipohypertrophy. Your skin may resemble scar tissue. This is thought to occur when fat cells grow inappropriately and make the skin look lumpy.


Diabetes Injection Site Risks

Injection site problems can occur in anyone who injects insulin. Lipoatrophy is more common in young women and is more likely to occur in people who use less purified forms of insulin, especially beef insulin. Hypertrophy is not an immune or allergic reaction and is not affected by the type of insulin used. However, it is more common in people who do not regularly rotate injection sites. Lipoatrophy and hypertrophy pose no health risks in and of themselves. Irregularities in insulin absorption can occur when insulin is injected into lumpy skin, though, so it is best to prevent them from occurring in the first place


What You Should Do

If you already have lipoatrophy, you may want to switch to a more highly purified and less immunogenic form of insulin, such as pork or preferably, human insulin. To get rid of the dents that are already there, you can try injecting human insulin into the margins of the dented area. This can build up fat deposits in the area and fill in the dents. However, this procedure is not a cure-all and it could be several months before you see any noticeable improvement. Talk to your doctor or diabetes educator about the best way to go about this.


If you have hypertrophy, switching to human insulin will not help. Your best bet is to avoid injecting into existing lumps and to rotate injection sites to prevent the further formation of skin lumps.


Diabetes Injection Site Problem Prevention

To prevent lipoatrophy, try switching to human insulin if you haven’t already done so. Both lipoatrophy and hypertrophy can be prevented by rotating the injection site. Where you decide to inject insulin is up to you. Whatever you decide, the important thing is to inject at different sites within the body to prevent skin problems. Some people find that rotating all injections within one general area such as the abdomen works well.  Other people get better results by doing all morning injections in one general area such as at the buttocks and all evening injections in another area such as the abdomen.

Within these general areas, it is best to change the exact site of injection from day to day. Divide the body area into sites about the size of a quarter. Try to make each new injection at least a finger-width away from the last shot. You may want to figure out a way to remember where you injected your last shot. Once you have used all the available injections sites, you can then start over in the same body area.


In rotating sites, keep in mind that insulin is absorbed differently from different parts of the body. The abdomen is frequently used because insulin is absorbed most quickly and consistently from this site. It is absorbed more slowly from the arms and slower still in the legs and buttocks. However, if you have actively working your muscles in these areas, insulin may be absorbed more quickly. Every person is different, with different amounts of muscle and fat in the various areas of the body. Try to develop an awareness of how your own body absorbs.


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Sources and References

  • The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette


  • Insulin structure and function by John Mayer, Faming Zhang and Richard DiMarchi


  • Improvement of Insulin Injection Technique: Examination of Current Issues and Recommendations by Geralyn Spollet, Steven Edelman, Claudia Walter et al


  • The Case for Using Human Insulin by Mayer Davidson



Rich Health Editorial Team

Health Research

Rich Health Editorial Team is made up of medical practitioners and experienced writers who provide information for dealing with health issues in a simple and easy-to-understand manner