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RE: [IP] Re:Muscle injections



I was curious. I found these:

http://www.eboncall.org/CATs/2067.htm
Apparently there's no significant difference between intramuscular and
intravenous administration.

http://care.diabetesjournals.org/cgi/content/abstract/13/5/473
Hypoglycemia risk during exercise after intramuscular injection of insulin
in thigh in IDDM

http://tinyurl.com/5mwnc
Some guy (type 1) was resistent to subcutaneous insulin so they studied
him using intramuscular. "... long-term intramuscular insulin therapy is a
feasible alternative to intravenous or intraperitoneal insulin in patients
with well-demonstrated resistance to subcutaneous insulin."

http://tinyurl.com/4m8cg
"The faster absorption rate and shorter duration of action, together with
the higher day-to-day variation in absorption, led us to conclude that
intramuscular injection of NPH insulin should be avoided."

I didn't find any mention of adverse effects besides possible more pain or
bruising. It seems the big issue is the difference in adsorbtion, and risk
of hypoglycemia if you get it wrong. There's a lot of mention of
accidental intramuscular injection.

It looks to me like there shouldn't be a real issue for correction
boluses. It would seem risky for delivering basal or meal insulin this
way.

But I bet endos tend to roll their eyes whenever patients do ANYTHING that
goes against what's conventionally taught -- and we're taught to avoid
intramuscular so we get consistent results.

-----Original Message-----
From: probent
Sent: Sunday, December 19, 2004 21:32

    I do IM injections (rarely) for the same reason. It can be
uncomfortable. The endo that I visit just raises his eye brows when it is
mentioned. Does any one know why docs raise their eye brows and give
warnings when IM shots are mentioned?     Peter 1

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had a name of smime.p7s]
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