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Thread: What happens to insulin injected into muscle?

  1. #1

    Default What happens to insulin injected into muscle?

    I am relatively new to the forum and have only been dealing with diabetes for 10 months. My 4 year-old son was diagnosed last February. We started off with MDI (lantus and novolog) and moved to the Omnipod in July. We have always had the pods on his tummy – his preference, but he really has no fat there, or anywhere else.

    His insulin needs have continued to climb since July, but he also seems to be growing inches every month, so we have attributed the increase need to that. We have been working and working on getting him to try another place for the pod, but he was just too scared. After lots of begging and bribing, he finally agreed to the thigh. My endo is not a fan of this because of the chance to hit the muscle - which I understood to mean the insulin would be absorbed too quickly and we would see a big drop followed by a big rise. It looked like that’s what happened the first time we tried the thigh. His post breakfast BG was 84 – which is unheard of in our house. We had to feed the insulin and back off basals all day. We moved the pod back to his tummy that night. After reading a thread on this forum of others who have successful used the thigh, we decided to try again. Evin must have picked up on our worries after the first attempt, because it took lots of begging and bribing to get him to try again.

    So to make a long story short, yesterday was the day. And again we are chasing lows all day and all last night. But, we have not seen any high numbers at all. I would have thought that if we hit muscle, sooner or later we would see the blood sugars climb. We have decreased his basal as much as 80% and boluses by 50% and we are sitting between 60 and 100 - not what I expected...and we are checking every hour.

    So my questions are….is this what happens to insulin in muscle? Shouldn’t we be seeing some high numbers once that insulin is quickly absorbed by the muscle? Part of me wants to believe that the absorption in the tummy has been bad all along – we have never gone more than 3 days without changing a basal or bolus rate.

    Thanks for your time,
    Kelli
    Mom to Evin (7) dx 2/27/07 and Omnipodding since 7/13/07. A love/hate relationship with the Dexcom since 7/12/08
    his twin Donovan and
    older brother Eoin - their guiding star
    Watch our video: Evin's Omnipods

  2. #2

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    I'm no doctor but it sounds like you have found something that works. While the doctor is correct that the insulin is delivered faster, is this a bad thing with the right changes to other things? I mean, someone please correct me if I am wrong, but, if he has lower numbers all the time, couldnt you just back off on the dosages, keeping the numbers in the 100's. It doesnt sound to me (or have I had any negative experiences) from hitting the muscle in my leg.
    Chris Gross

    Type 1 Diabetes: 6 years

  3. #3

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    Ive accidently given Kat an injection in the lower back before (when aiming for the butt at 4:45 am). I called my mother totally freaked out and she basically said that giving a shot in the muscle hurts like dickens but wont do any major damage as far as absorbtion. She said somewhere, in that "fat free" area there is subcutanious fat. You could give it in the calf if you had to, according to her. Which sounds gross to me,lol. So if your giving it in an area of supposed "no fatty tissue" even though its in an area where shots are normally given, I would say theres subcutanious fat in there somewhere, and if its working dont try to fix it.
    Carolyn, age 41, Mom to:
    Katerina 10 yrs old dx'ed T1 @ age 3,on 9/10/04, Lantus and Novolog MDI
    Austin age 12, non-D
    Kaitlyn age 15, non-D, dx'ed asthma age 2 yrs
    Amanda age 18, non-D, dx'ed VWD, Type 2A 6/09
    Daughter to Linda, age 61, dx'ed T1 @ age 10, 1959
    Katerina at "Camp A1c at Cha-La-Kee 2010"

  4. #4

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    It would hurt incredibly bad if you hit a muscle with a site. Maybe this is part of his fear?
    Jamie - Mom to Julia,
    currently 7 yrs old,
    dx'd 01/22/06,
    pumping since 11/10/06
    My Blog

  5. #5

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    Kelli~
    We started the pump in May of 07. The only place my daughter would put the site was the rear. Like you after bribing, and begging she let me try a different spot. We also tried the thigh, and are still using it.
    This is what I've found after a little over two months using the thigh. Any more exercise than normal using the thighs Abby's insulin works faster. Bike riding, in door rock climbing, PE, dancing, obviously things that that involve heavy leg use. I use a temp basal during those type of activities.
    I think your seeing better absorption using the thigh, and you could have possibly hit a muscle. What was his day like, anything out of the ordinary? Could he be getting sick?
    Lanae
    Proud Mom of
    Tyler (19)
    Abby (10) dxd 1/07 Type 1
    Pumping w/MM522 05/02/07
    Novolog/Sure T sites
    CGMS- 8/11/08
    Hashimotos Disease 6/08

    "Endless"

  6. #6

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    Thanks for the replies. It’s good to know that Evin would feel pain if the canula is in the muscle. He hasn’t said that at all – in fact it’s been the exact opposite. He thinks the thigh is more comfortable than the tummy. And he is so careful about pulling down his pants – something that really surprises me, but my kid has consistently surprised me since he was diagnosed!

    Lanae, thanks for mentioning using a temp basal when Abby is using the thigh. I am beginning to lean that way. The only problem is my son only has too speeds – very fast and asleep so it will definitely take some tweaking to make this work. In fact, I kept him home from preschool today because his numbers have been so low.

    I’m going to keep this pod on for the full 3 days and see how it goes.

    Thanks again,
    Kelli
    Mom to Evin (7) dx 2/27/07 and Omnipodding since 7/13/07. A love/hate relationship with the Dexcom since 7/12/08
    his twin Donovan and
    older brother Eoin - their guiding star
    Watch our video: Evin's Omnipods

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