Absorption of NPH (Isophane) Insulin in Resting Diabetic Patients: Evidence for Subcutaneous Injection in the Thigh as the Preferred Site

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Abstract
The absorption kinetics of NPH (isophane) insulin injected subcutaneously into the abdominal wall and subcutaneously (SC) and intramuscularly (IM) into the thigh was studied in 11 Type 1 diabetic patients. The thickness of the subcutaneous adipose tissue layer was measured by ultrasound.NPH (isophane) insulin injected IM into the thigh was absorbed faster than NPH insulin injected SC into the thigh (T50%, IM 8.0 ± 0.6 h and SC 10.3 ± 0.7 h,p< 0.05). No difference in T50%values was found for injection into the abdominal wall (9.7 ± 1.2 h) compared with the thigh. The mean absorption rate from 1.5 to 13.5 h after injection was higher after injection IM into the thigh (6.4 ± 0.3 % of initial dose injected absorbed per h) than after SC injection into the thigh (5.2 ± 0.3 % h−1) and SC into the abdominal wall (5.1 ± 0.3 % h−1) (pp< 0.02)). The study provides further evidence that the subcutaneous tissue of the thigh is the preferred injection site for NPH insulin.