Frid A, Gunnarsson R, Güntner P, Linde B
Department of Medicine, Falu Lasarett, Huddinge, Sweden.
Diabetes Care. 1988 Jan;11(1):41-5. doi: 10.2337/diacare.11.1.41.
Recent studies have shown that with the injection technique presently recommended to diabetic patients, accidental intramuscular injection of insulin is liable to occur quite frequently. In this study, the simultaneous absorption of 125I-labeled soluble human insulin (5 U) from subcutaneous and intramuscular injection sites in the thigh and abdomen was measured for 3 h in 10 insulin-dependent diabetic subjects to evaluate the importance of accidental intramuscular injection for insulin absorption in the resting state. Injection sites were located with computed tomography of the thigh and abdomen. From a superficial part of the thigh musculature, the absorption rate was at least 50% higher than from the adjacent subcutaneous tissue, the time until 50% of the initial activity remained (t1/2) being 123 +/- 14 and greater than 180 min, respectively (P less than .001). No difference in absorption rates was found between the two tissues in the abdomen (t1/2 84 +/- 6 vs. 93 +/- 7 min, NS). The results suggest that in the thigh, accidental intramuscular injections will considerably increase the variability of insulin absorption and may impair glycemic control in insulin-dependent diabetic patients. Furthermore, the influence of accidental intramuscular injection on insulin absorption seems to vary among injection regions.
近期研究表明，采用目前推荐给糖尿病患者的注射技术时，胰岛素意外肌内注射相当频繁地发生。在本研究中，对10名胰岛素依赖型糖尿病受试者在大腿和腹部的皮下及肌内注射部位同时吸收125I标记的可溶性人胰岛素（5 U）的情况进行了3小时的测量，以评估意外肌内注射对静息状态下胰岛素吸收的重要性。通过大腿和腹部的计算机断层扫描确定注射部位。在大腿肌肉组织的浅表部位，吸收率比相邻皮下组织至少高50%，初始活性剩余50%的时间（t1/2）分别为123±14分钟和大于180分钟（P＜0.001）。在腹部，两种组织的吸收率没有差异（t1/2分别为84±6分钟和93±7分钟，无显著性差异）。结果表明，在大腿部位，意外肌内注射会显著增加胰岛素吸收的变异性，并可能损害胰岛素依赖型糖尿病患者的血糖控制。此外，意外肌内注射对胰岛素吸收的影响似乎在不同注射区域有所不同。
