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Clinically important differences in insulin absorption from abdomen in IDDM

A Frid1, B Linde

  • 1Department of Medicine, Huddinge Hospital, Sweden.

Diabetes Research and Clinical Practice
|August 1, 1993
PubMed
Summary

Insulin absorption and glucose control differ based on abdominal injection site. Injecting insulin above the umbilicus leads to faster absorption and better glucose lowering compared to below the umbilicus.

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Area of Science:

  • Endocrinology
  • Metabolism
  • Pharmacokinetics

Background:

  • Subcutaneous insulin absorption kinetics are crucial for glycemic control in diabetes.
  • Variability in insulin absorption from abdominal sites may impact treatment efficacy.

Purpose of the Study:

  • To compare insulin absorption rates and glycemic effects from subcutaneous injection sites above and below the umbilicus in patients with insulin-dependent diabetes mellitus (IDDM).

Main Methods:

  • Radiolabeled insulin ([125I]Actrapid Human) absorption was monitored by radioactivity disappearance and plasma immunoreactive free insulin (IRI) appearance.
  • Adipose tissue blood flow (ATBF) was measured using the 133Xe-washout technique.
  • Ultrasound determined subcutaneous fat depth, and plasma glucose levels were tracked.

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Main Results:

  • Significantly less radioactivity remained at the upper abdominal site (42%) compared to the lower site (60%) after 180 minutes (P < 0.001).
  • Upper abdominal injections yielded a greater area under the curve for plasma insulin (3306 vs. 2357 mU/l per min; P < 0.01) and a more pronounced glucose-lowering effect (P < 0.05).
  • No significant difference in ATBF was observed between the two injection sites.

Conclusions:

  • Clinically significant differences exist in insulin absorption within the abdomen based on injection location.
  • Epigastric insulin injections promote more rapid absorption and enhanced glucose-lowering effects compared to injections below the umbilicus.