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Diabetes Disaster Averted #31: Injection Site Technique

I saw an obese long-term person with Type 2 diabetes who was experiencing widely fluctuating BGs and had had two hospitalizations within the previous six months, one for a BG of 28mg dl and one for an infested hair follicle (BG 413 mg/dl in ER)….

A1c was 7.3%. Her verbal account of injection technique seemed correct but then she stated she administered only to her left upper, outer, gluteal area, “as I was told when I was started on insulin!”  On observation, this area looked like an old baseball glove, it had so much lipodystrophy!  On both inpatient admissions, no one had assessed or asked her about injection sites.  I taught her about site rotation and gave her a cartoon grid to use as a guide.

Lesson learned:

Assess injection technique and sites on all patients admitted who have been on insulin prior to admission.  Medical professionals should witness patient doing own injections prior to discharge.

Jeanne Eaton RN, CDE, CPT

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