Effect of different pattern of insulin injection on glycemic control in type 1 diabetic patients

Treatment of type 1 diabetes mellitus is hindered by the often large fluctuations in the blood glucose concentration experienced by affected individuals. It seems that variation in the rate of absorption of insulin from the subcutaneous injection sites may be an important factor causing these fluctuations. In this study the effectiveness of different patterns of insulin injections on glycemic control were investigated in this type of diabetes. Insulin injections were given in the abdomen for 3 weeks (standard rotational pattern) and rotated among arms, abdomen and thighs for 3 weeks (irregular rotational pattern) and finally were performed prebreakfast injections in abdomen and presupper injections in thigh for 3 weeks (regular rotational pattern). Fasting blood glucose levels were measured weekly also the end of every period, serum fructoseamine value were also determined. Statistical analysis of data showed that there is significant difference between mean serum fructoseamine values during standard, regular and irregular rotational patterns (p<0/001) and mean serum fructoseamine values during standard rotational pattern were lower than the corresponding values during regular (282/8 vs 376/7 µmol/l respectively) and irregular (282/8 vs 461/2 µmol/l respectively) rotational patterns and mean serum fructoseamine values during regular rotational pattern were lower than the corresponding values during irregular rotational pattern.The finding of this study suggests that injections pattern should be rotated using all of the available sites in an anatomic area before moving to the next is more effective method for glycemia control.