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December 24, 2000

Blood Tests and Insulin Injections

Question from Connecticut, USA:

My 10 year old son is uncomfortable with having his pants pulled down for a shot, but his butt is part of the rotation. Is there any way to make this easier for him?

Answer:

Some patients, including some doctors with diabetes, do indeed inject through clothing, but usually into the anterior thigh. I don’t think it is a good idea to inject through blue jeans, underpants and perhaps a pocket, not because of the risk of infection, but because it would require using a bigger needle than the BD UltraFine, and it would be harder to be sure that the insulin had gone in subcutaneously. One suggestion would be to try ‘cargo’ pants which are fashionable and have a zip just below the knee so that you can easily access the thigh for any school time injections.

DOB
Additional comments from Stephanie Schwartz, diabetes nurse specialist:

You might to give thought to eliminating the buttocks as an injection site. You can use the upper outer aspect of his hip instead, and that would do away with need for you to pull his pants all the way down. Alternatively, you can skip this part of his body all together as I’m certain his has plenty of other places to use. I suspect that, at this age, your son’s body is changing, and it is not usual for boys to become more modest.

SS
Additional comments from Betty Brackenridge, diabetes dietitian:

Through-the-clothing shots are certainly common. There is even an old study (with whiskers on it by this time, I suspect) that showed, as I recall, no difference in control and no increased incidence of infections. The only caution we pass on to folks is the possible necessity of using a longer needle when doing so, depending on the thickness of the cloth. Since boys’ pants plus undies would be a bit thick, I’d want to be sure that the child was using regular length needles, not shorties, for these particular injections.

BB

[Editor’s comment: You can inject through clothing. See The Safety of Injecting Insulin Through Clothing and Injecting insulin through clothing was safe and convenient.

JSH]