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Unchanged Insulin Absorption After 4 Days' Use of Subcutaneous Indwelling Catheters for Insulin Injections

  1. S Ragnar Hanas, MD,
  2. Sten Carlsson, PHD,
  3. Anders Frid, MD and
  4. Johnny Ludvigsson, MD, PHD
  1. Departments of Pediatrics, University of Linkoping Linkoping, Sweden
  2. Medical Physics, University of Linkoping Linkoping, Sweden
  3. Uddevalla Hospital Uddevalla Department of Internal Medicine, University of Linkoping Linkoping, Sweden
  4. University of Lund Lund Department of Pediatrics, University of Linkoping Linkoping, Sweden
  1. Address correspondence and reprint requests to Ragnar Hanas, MD, Department of Pediatrics, Uddevalla Hospital, S-451 80 Uddevalla, Sweden. E-mail: ragnar.hanas{at}bll.se

Abstract

OBJECTIVE Since 1985, we have used indwelling catheters (Insuflon, Maersk Medical, Lynge, Denmark; Chronimed, Minnetonka, MN) to lessen pain when injecting insulin. However, some patients experience a rise in blood glucose after using indwelling catheters for a few days. We therefore studied the absorption of 125I-labeled insulin when using indwelling catheters.

RESEARCH DESIGN AND METHODS Five men and five women participated (age 18–25 years, C-peptide negative, HbA1c 9.0 ± 1.0% [mean ± SD, DCA-2000 method], diabetes duration 5–21 [median 9.5] years). After thyroid blockage with potassium iodide, we injected 5IU of 125I-labeled short-acting insulin subcutaneously in the abdomen (“ordinary injection”) and 5 IU on the contralateral side through an indwelling catheter (“catheter injection”). The injection/insertion area was free of lipohyper- and lipohypotrophies. Disappearance rate was measured for 180 min with a gamma camera. The patients injected all premeal injections of short-acting insulin through the same indwelling catheter in the following 4 days. The investigation procedure was repeated day 3 and 5.

RESULTS We found no statistically or clinically (95% CI) significant difference in residual activity of 125I-insulin after 60 min or in time for 50% of the injected depot to disappear (T-50%) among catheter injections on day 1, 3, and 5; ordinary injections on days 1, 3, and 5; or catheter and ordinary injections on days 1, 3, and 5, respectively. HbA1c correlated both to T-50% (r = 0.73, P = 0.016) and residual activity of 125I-insulin after 60 min (r = 0.69, P = 0.028), indicating that patients with a slower absorption will have a less ideal metabolic control when using premeal bolus injections.

CONCLUSIONS We conclude that using indwelling subcutaneous catheters for insulin injections for up to 4 days does not affect the absorption of short-acting insulin.

  • Received May 25, 1996.
  • Accepted October 16, 1996.
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