Injecting Insulin

Injecting Insulin

INJECTING INSULIN
THROUGH CLOTHING

Ever since Semmelweis,
Lister, and Pasteur, doctors and nurses have been taught to follow sterile antiseptic
technique, especially where a medical procedure (such as an injection) breaks
the skin. Thus those diabetics who must daily inject insulin have been taught
to remove clothing, alcohol-swab the injection site, and otherwise preserve
maximum cleanliness. But some authorities state such precautions are unnecessary.
How clean is clean enough? There has been much argument.
The American Diabetes Association's
professional journal "Diabetes Care" (Vol. 20, No. 3, March 1997)
published the results of a study by Doris Fleming, MSN, RN, CS, CDE; James Fitzgerald,
PhD; George Grunberger, MD; Scott Jacober, DO, CDE; and Melissa Vandenburg,
BSN, RN, CDE, in which 50 insulin-using diabetics performed injections both
by traditional antiseptic techniques and through a single layer of clothing.
Was there any significant difference, either in diabetes control, or in side
effects such as nuisance infections?
The researchers were thorough. All participants
had a skin assessment, A1C, and leucocyte count before the test, at the 10-week
point (halfway), and again at completion. Problems, benefits, type of clothing
(from nylon to denim) and other comments were recorded by the subjects in an
"injection log."
Over the 20-week period, approximately
13,720 injections were performed by the participants. None of the subjects experienced
erythema, induration, or abscess at injection sites. Neither the glycated hemoglobin
levels nor the leucocyte count differed between the conventional or the experimental
(through clothing) injection regimens. During the injection-through-clothing
phase of the study, participants' logbooks recorded only minor problems, such
as small bloodstains or bruising. Subjects reported that insulin injection through
clothing offered benefits such as convenience and saving time.
The researchers' conclusion: "It
is safe and convenient to inject insulin through clothing."
From the VOICE Editor:
I have made many injections through my clothing, without problems. However,
I would recommend you do this only if you and your clothes are clean. I note
that if you are on immunosuppressive therapy (or otherwise immune-compromised),
you might need to be more cautious of infection, and avoid this practice. I
saw that the above study was also noted in New England Journal of Medicine's
newsletter "Healthnews" (March 1997).