Repetitive injection of insulin causes subcutaneous amyloid deposits leading to impaired blood glucose control due to delayed absorption of the drugs. Amyloid deposits in abdominal wall is detected by CT examinations. Proper selection of the injection site avoiding amyloid deposits is essential. The present study was conducted to establish a novel method for the management of injection site avoiding amyloid deposits.

The present study included 50 diabetic patients who were treated with insulin over 5 years. Two weeks CGM was performed using Free Style Libre Pro. In the case of significant day to day variation in blood glucose control, abdominal wall CT examination was performed. In front abdominal wall, 36 small circular zones were set to identify the site of injection, named “no-injection zone” which caused impaired blood glucose control due to delayed absorption of insulin by amyloid deposits. Site rotation seat was developed for the management of insulin injection site.

Among 50 patients, 33 patients were shown to have “no-injection zone” (average; 8.5 zones). In the patients whose HbA1c is over 8% (n=15), a significant improvement in HbA1c from 9.0% to 7.8% was observed without any changes in daily dose of long-acting insulins by the management of injection site.

The management of injection site using CGM, abdominal CT and site rotation seat improves blood glucose control.


H. Nishihara: None. T. Sudo: None. J. Sasaki: None. N. Hasegawa: None. M. Ishii: None. C. Koizumi: None. M. Hiraoka: None. S. Ikejima: None. A. Hirai: None. M. Suzuki: None.

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