Lately I’ve been having a lot of trouble avoiding injecting through blood vessels. I don’t get it, I didn’t bleed at all for the first 2 months of injecting insulin, and now all of a sudden it’s like a 50/50 chance I bleed. It hasn’t been a big deal when I’m injecting Novolog because usually that’s only 1-3 units at a time, but the other day I guess I hit a vein while injecting my 12 units of Lantus and I went from 109 to 40 in 25 min - my new record low. I’m assuming a large chunk of the lantus went right into my bloodstream and that’s why it hit me so fast.
I usually inject into my inner thigh (where my endo suggested) or my hip. I’m fairly lean so I find it hard to inject into my stomach (I almost always get a big ol’ blood blister and then a nasty bruise). And I always try to pull the subcutaneous tissue up and pinch when I inject.
Any suggestions guys? I could use some tips if anyone’s had a similar experience!
Using the inner thigh sounds wrong to me. I always use the upper thigh or the buttocks for basal. If this problem does not disappear you can switch to two shots of Levemir per day. In contrast to Lantus the Levemir binds to the albumin of the blood. Thus it makes no difference to inject it into the blood stream by accident.
yeah i second @Holger s suggestion of going away from the inner thigh to either frontal or lateral thigh, as well as buttocks. there i think the possibility of hitting a vein is smaller.
what sort of needles do you use, how long are they? if you tell me you are lean, i would not use anything longer than 5mm.
while injecting into the bloodstream isn’t dangerous, i understand it can be pretty annoying.
What size needle are you using? I’m also very lean and when on MDI used 4mm pen needles. I used the love handle area a lot, but also found my stomach was okay, especially for the smaller doses.
I use 4mm needles. I’ll have to try the front/lateral thigh area. I feel like I wouldn’t be able to reach my butt! I’m not sure I’m that coordinated, haha. I think I’ve also gotten out of the habit of injecting at a 45 degree angle, now that I think about it. So I’ll have to bring that habit back.
I know I’ve come across a lot of people who say injecting accidentally into the bloodstream isn’t dangerous, but if Lantus is meant to be injected to into subQ tissue…injecting it into the bloodstream seems like a pretty bad situation. I can’t think of any other reason for my BG to plummet like it did. I’ve also read about similar experiences, which sounded much more terrifying because they were on doses sometimes 3x as large as mine.
yeah i think with lantus it is not as good to inject into blood. with levemir that would be no problem.
i think with 4mm needles it is not recommended to inject in a 45degree angle, you should be able to inject straight. butt really isnt so difficult, you just jam that pen into your gluteus maximus, you dont need to see there or something. no coordination needed
i am sure you’ll get this stuff figured out, good luck!
Concur… Injecting into inner thigh sounds horrid! I use front/outside of thighs or butt and have never had an issue… Occasionally I’ll nick a capillary and might see a tiny bit of blood and maybe small bruises for a few days but the blood vessels in these areas near the skin aren’t big enough to inject “into”
Back of the upper arm was one of my old faves when I was on MDI. I’ve recently rediscovered it as a result of losing abdominal real estate due to scaring, 3-inch clearance for CGM etc. Kind of awkward location for a pump infusion set but quite pain free and I don’t have to use those dratted angled sets that cause me so much pain and trouble.
You’ve got your concern about post-injection bleeding backwards – much more important those small bolus injections don’t bleed, because they are small. It can really throw your control off when you inject 3U and 1-2U bleed right back out.
To help prevent the bleedout, leave the needle fully inserted in the skin after finishing the injection for 30-60 seconds. Then slowly retract. If you can manage to pull it out halfway (2mm) and hold it there for another 30 seconds, this helps even more. I’ve found this gradual removal procedure helps a lot with bleeding, especially if you can pull off the two-stage removal… Gives the insulin a little time to disperse, and any capillary tissue penetrated to close up a bit while the “channel” cut by the needle is still blocked.
I think doc got inner and outer thigh confused. Inner is getting close to artery, doubt if your going deep enough but I always injected on top front of thigh moving toward out edge. Back of arms was always easy if you place arm against door jam while you stand in doorway using jam to push more of your tricep towards you. Once in while I’d hit a blood cell but not veins.
I haven’t used the inner thigh since I was a little tiny kid.
Lantus only went in the muscley upper thigh or buttcheek for me.
Even then, I wasn’t very well controlled on lantus OR levemir and they both gave me welts at the injection site. Some people are highly sensitive to the preservatives used.
Can you go on a pump soon/eventually?
