Injection site rotation: difference between revisions
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| Revision 3 — 11:03, 28 Sep 2024 StabilityStig (talk) add the beyond-use interval with the storage condition it assumes 2,155 bytes ±0 | Revision 4 — 08:17, 7 Oct 2024 TitrationTheo (talk) fix a broken wikilink 2,900 bytes +745 | ||
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| 10 | The evidence base is largely from insulin therapy, where lipohypertrophy is common, is associated with unpredictable glycaemic control, and resolves slowly when the affected area is rested. Its relevance to weekly peptide administration is less well characterised, since injection frequency is roughly one seventh of that in basal-bolus insulin therapy.{{r|gentile2016}} | 10 | The evidence base is largely from insulin therapy, where lipohypertrophy is common, is associated with unpredictable glycaemic control, and resolves slowly when the affected area is rested. Its relevance to weekly peptide administration is less well characterised, since injection frequency is roughly one seventh of that in basal-bolus insulin therapy.{{r|gentile2016}} |
| 11 | 11 | ||
| + | 12 | Two rotation patterns are distinguished. Rotating within a region — moving a couple of centimetres each time while staying in the same anatomical area — preserves that region's absorption characteristics. Rotating between regions changes them as well.{{r|ada2024}} | |
| + | 13 | ||
| 12 | == Lipohypertrophy == | 14 | == Lipohypertrophy == |
| 13 | Lipohypertrophy is a local proliferation of subcutaneous adipose tissue at sites of repeated injection. It presents as a soft or rubbery thickening, often more readily felt than seen, and is frequently painless — which is part of why it is under-recognised.{{r|gentile2016}} | 15 | Lipohypertrophy is a local proliferation of subcutaneous adipose tissue at sites of repeated injection. It presents as a soft or rubbery thickening, often more readily felt than seen, and is frequently painless — which is part of why it is under-recognised.{{r|gentile2016}} |
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| 15 | Absorption from affected tissue is reduced and more variable. In insulin therapy this produces unexplained variability that persists until the affected area is rested, and continued injection into it is self-reinforcing because reduced sensation makes the site attractive. | 17 | Absorption from affected tissue is reduced and more variable. In insulin therapy this produces unexplained variability that persists until the affected area is rested, and continued injection into it is self-reinforcing because reduced sensation makes the site attractive. |
| 16 | 18 | ||
| + | 19 | Whether repeated weekly injection of a peptide produces the same lesion is not established. Frequency is much lower, but the mechanical and pharmacological insults are qualitatively similar, and the literature on this specific question is thin.{{r|richter2012}} | |
| + | 20 | ||
| 17 | == References == | 21 | == References == |
| 18 | {{reflist}} | 22 | {{reflist}} |
| 19 | <ref name="ada2024">American Diabetes Association. "Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes." ''Diabetes Care'' 47(Suppl 1) (2024).</ref> | 23 | <ref name="ada2024">American Diabetes Association. "Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes." ''Diabetes Care'' 47(Suppl 1) (2024).</ref> |
| 20 | <ref name="gentile2016">Gentile S, Strollo F, Ceriello A. "Lipodystrophy in insulin-treated subjects and other injection-site skin reactions: are we sure everything is clear?" ''Diabetes Therapy'' 7(3):401–409 (2016). PMID 27503118.</ref> | 24 | <ref name="gentile2016">Gentile S, Strollo F, Ceriello A. "Lipodystrophy in insulin-treated subjects and other injection-site skin reactions: are we sure everything is clear?" ''Diabetes Therapy'' 7(3):401–409 (2016). PMID 27503118.</ref> |
| + | 25 | <ref name="richter2012">Richter WF, Bhansali SG, Morris ME. "Mechanistic determinants of biotherapeutics absorption following SC administration." ''The AAPS Journal'' 14(3):559–570 (2012). PMID 22619043.</ref> | |
| 21 | 26 | ||
| 22 | {{DEFAULTSORT:Injection site rotation}} | 27 | {{DEFAULTSORT:Injection site rotation}} |