Insulin Injection Site Adverse Effect in a Type 1 Diabetes Patient: An Unusual Presentation

Abstract

Insulin is an integral part of Type 1 diabetes management. Patient education is of utmost importance to ensure proper injection technique for getting appropriate glycaemic control as well as to avoid injection site adverse effects. Commonest injection site adverse effect is lipodystrophy, attributable to localized manifestation of the pharmacological action of insulin. However, we present a case where incorrect injection technique led to an unusual presentation of injection site adverse effect. Apart from the abnormal skin changes, the incorrect technique also adversely affected the glycaemic control. Though less prominent, some marks are still evident one and a half years after correction of the injection technique. However, the glycaemic control has substantially improved. This emphasizes the need of proper patient education regarding insulin injection technique.

Keywords: Insulin injection technique; Patient education; Site rotation; Skin pigmentation.

[Table/Fig-1]:

Affected injection sites showing lipohypertrophy and injection scar marks of varying grades of pigmentation. a) Right arm; b) Left arm; c) Right thigh

[Table/Fig-2]:

Affected injection sites showing faded injection scar marks 1.5 years after correction of injection technique. a) Right arm; b) Left arm