
December 11, 2002
Blood Tests and Insulin Injections
Question from Northborough, Massachusetts, USA:
Just recently, I read that insulin should not be injected in the inner thigh, but, that said, I was told by my endocrinologist to use that site along with the outer and back of the thigh. We can also use very select few areas of the buttocks. Unfortunately, my son is young and has most of his favorite sites riddled with lipohypertrophy. Is it safe to inject with the short needle syringe in the inner thigh region? If it isn’t, why would my endocrinologist recommend it?
Answer:
I also have heard that some folks are advised to avoid the inner thigh for injection sites. I do not completely understand why. I’ve advocated that, for the most part, a subcutaneous shot is a subcutaneous shot. Certainly, some folks note changes in activities affect the blood flow to a spot and thereby affect the rate of insulin absorption: if you give a shot in the arms and then go rowing, you may note a change.
I do suggest that the lateral aspects of the hips or upper-outer portion of the buttocks be used rather than giving a shot in the middle of the buttocks cheeks. My rationale is this: the main nerve that goes from the spine to the leg, called the sciatic nerve, travels down the middle of the buttocks cheek of each leg. It is generally far too deep to be injured with a tiny insulin needle,, However, people tend to be creatures of habit and “give shots where they’re used to giving shots.” A Glucagon Emergency Kit needle could potentially reach the sciatic nerve, I fear, especially when the person giving the shot is all excited and pumped full of adrenaline because of the reason that glucagon is needed (a patient having a hypoglycemic seizure for example.) So in order to avoid the possibility of giving glucagon in the middle of the buttocks, I have patients practice giving any “rear-end” shot closer to the hips.
I suppose a similar argument could then be made for avoiding the inner thigh, but I am not aware of vital structures — only the relative decrease in muscle tissue there.
DS