The effect of skin thickness, subcutaneous fat and neddle lenght selecti̇on on the metaboli̇c control for subcutaneous injection of insulin

The purpose of insulin injection is to give medicine safely without any discomfort to the subcutaneous area. It is important to choose the right needle length to meet this goal. Patient and health staff decide needle length according to many factor such as physical, pharmacological and psychological. This study planned to reveal the impacts of needle length on metabolic situation, side effects of needle and patient satisfaction. At the same time skin thickness and subcutaneous fat tissue was measured for the efficiacy. Total 45 type 1 and type 2 patients who using insulin and followed in "Akdeniz University Hospital, Endocrinology and Metabolism Division" take part in this study. To measure patients' skin thickness and subcutaneous fat tissue, three different injection area were evaluated. Patients used injection into the abdomen with 4 mm needles during first three weeks. Then, they used injection into the thigh with 4 mm needles during next three weeks . Finally, they used injection into the arm with 4 mm needles during final three weeks After that patient used injection into abdomen with 8 mm needle during first three weeks. Then, they used injection into the thigh with 8 mm needles during next three weeks. Finally, they used injection into the arm with 8 mm needles during final three weeks. To verify glycaemia, average glucose level and fructosamine were evaluated after every three weeks. At the 9 th and 18 th weeks, patients pain level is evaluated by visual analog scale (VAS). Patients complications about insulin injection site (like bleeding, ecchymosis, lipodystrophy and dribble) were collected in daily data collecting form and this data was evaluated after every three weeks. When needles are compared in terms of glycaemia, no difference is determined between 4mm needles and 8mm needles. Patients prefered short needles, also, they reported less bleeding, ecchymosis and pain with short needles. It is determined that skin thickness is independent from age and sex, the skin thickness increased with BMI. There is no change in skin thickness in injected area. In this study, the thickest skin is in the abdomen with 3mm. This result supports that diabetic patients can use short needle safely as well. Key Words: Skin Thickness, Needles Length, Glycemic Control