Subcutaneous adipose tissue thickness in adults - correlation with BMI and recommendations for pen needle lengths for subcutaneous self-injection

Ludescher, Burkhard; Rommel, Marc; Willmer, Tobias; Fritsche, Andreas; Schick, Fritz; Machann, Juergen

doi:10.1111/j.1365-2265.2011.04132.x

Cited by 36 publications

(30 citation statements)

References 20 publications

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“…Gibney et al 8 and Hirsch et al 15 (separate reports on the same study) measured SC fat depth at single locations in the thigh, arm, abdomen, and buttock. Studies by Ludescher et al 16 and Sim et al 14 (where 8-10 measurements were taken and averaged for each body site) largely confirmed the ultrasound study findings from a single site.…”

Section: Sc Thicknesssupporting

confidence: 57%

New Insulin Delivery Recommendations

Frid

Kreugel

Grassi

et al. 2016

Mayo Clinic Proceedings

224

278

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Many primary care professionals manage injection or infusion therapies in patients with diabetes. Few published guidelines have been available to help such professionals and their patients manage these therapies. Herein, we present new, practical, and comprehensive recommendations for diabetes injections and infusions. These recommendations were informed by a large international survey of current practice and were written and vetted by 183 diabetes experts from 54 countries at the Forum for Injection Technique and Therapy: Expert Recommendations (FITTER) workshop held in Rome, Italy, in 2015. Recommendations are organized around the themes of anatomy, physiology, pathology, psychology, and technology. Key among the recommendations are that the shortest needles (currently the 4-mm pen and 6-mm syringe needles) are safe, effective, and less painful and should be the first-line choice in all patient categories; intramuscular injections should be avoided, especially with long-acting insulins, because severe hypoglycemia may result; lipohypertrophy is a frequent complication of therapy that distorts insulin absorption, and, therefore, injections and infusions should not be given into these lesions and correct site rotation will help prevent them; effective long-term therapy with insulin is critically dependent on addressing psychological hurdles upstream, even before insulin has been started; inappropriate disposal of used sharps poses a risk of infection with blood-borne pathogens; and mitigation is possible with proper training, effective disposal strategies, and the use of safety devices. Adherence to these new recommendations should lead to more effective therapies, improved outcomes, and lower costs for patients with diabetes.

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Section: Sc Thicknesssupporting

confidence: 57%

New Insulin Delivery Recommendations

Frid

Kreugel

Grassi

et al. 2016

Mayo Clinic Proceedings

224

278

View full text Add to dashboard Cite

show abstract

“…Treatments for RA, such as the Enbrel and Benepali, are administered by subcutaneous (SC) injection [6,9]. This route of administration is not uncommon, particularly in chronic diseases, such as RA, diabetes, and multiple sclerosis [10][11][12]. A number of different devices are available for SC injection (prefilled syringes and autoinjector devices), with selection of device being influenced by a number of factors, including physician and patient preference [13].…”

Section: Introductionmentioning

confidence: 99%

Perceptions and Preferences of Two Etanercept Autoinjectors for Rheumatoid Arthritis: A New European Union-Approved Etanercept Biosimilar (Benepali®) Versus Etanercept (Enbrel®) - Findings from a Nurse Survey in Europe

et al. 2016

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“…Differences in distribution and thickness of subcutaneous fat according to gender have been described, as well as its correlation with BMI, but further studies would be needed to clarify potential associations with the cannulation technique. 51 Regarding the influence of chronic health conditions in DPIVC, it is believed that a higher frequentation of the health system would generate a higher use of vascular lines, which would derive in a progressive fibrosis of the vessel's walls. The use of vesicant intravenous infusions during hospital attention is another common factor potentially affecting this group of population, which could specially be present in patients receiving IV chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Defining risk factors associated with difficult peripheral venous Cannulation: A systematic review and meta-analysis

et al. 2020

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Peripheral venous catheterization is a common technique in hospitals which is not always successful, resulting in multiple punctures and degradation of the vessels. This scenario, which we have termed 'difficult peripheral venous access', is associated to delays in care, obtention of samples or diagnosis, as well as a higher use of central catheters. This study intends to identify risk factors associated to the incidence of 'difficult peripheral venous access' in adults at hospital. We designed a systematic review of published studies (protocol PROSPERO 2018 CRD42018089160). We conducted structured electronic searches using key words and specific vocabulary, as well as directed searches in several databases. After validity analysis, we selected 7 studies with observational methodology. We found great variability in the definition of 'difficult peripheral venous access' and in the variables proposed as risk factors. Statistically significant factors through studies include demographic and anthropometric variables (gender, Body Mass Index), as well as medical and health conditions (diabetes, renal insufficiency, parenteral drug abuse, cancer chemotherapy), together with variables related to the vein or vascular access (vein visibility and palpability, vessel diameter, previous history of difficulty). Some studies have also considered variables related to the professional performing the technique. Meta-analyses were carried out for gender and obesity as potential risk factors. Only obesity appeared as a statistically significant risk factor with OR of 1.48; 95% CI (1.03 to 1.93; p = 0.016). Methodological heterogeneity prevented the development of further meta-analyses. It is essential to design future studies with diverse hospital populations, in which a wide selection of potential risk factors can be studied in a unique analysis. Our work identifies the most relevant variables that should be included in those studies.

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Subcutaneous adipose tissue thickness in adults - correlation with BMI and recommendations for pen needle lengths for subcutaneous self-injection

Abstract: The data, with correlation between BMI and fat thickness at different injection sites in relation to gender, provide guidance in selecting an adequate pen needle length for deep and safe subcutaneous self-injection. WHR was a much weaker predictor when compared to BMI.

Cited by 36 publications

References 20 publications

New Insulin Delivery Recommendations

New Insulin Delivery Recommendations

Perceptions and Preferences of Two Etanercept Autoinjectors for Rheumatoid Arthritis: A New European Union-Approved Etanercept Biosimilar (Benepali®) Versus Etanercept (Enbrel®) - Findings from a Nurse Survey in Europe

Defining risk factors associated with difficult peripheral venous Cannulation: A systematic review and meta-analysis

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