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Skin and insulin injections

  1. Gastroepato
  2. Diabetology
  3. Skin and insulin injections
  4. Type 1 or type 2 diabetes mellitus
  5. Diabetes. What are we talking about?
  6. Recommendations for screening
    and diagnosis of gestational diabetes
  7. The checks to be performed in the routine diabetic patient

doctor's notes Claudio Italiano


The skin is the shell of our body. It acts as a means of protection and communication and interaction with the outside world. Many people need to get more injections through their skin every day to stay healthy; we are talking, of course, of diabetic patients in insulin therapy. At each injection, they must penetrate their skin, to overcome the barrier it represents and reach the subcutaneous tissue where the insulin is released and acts. However, when practicing insulin injections, you run the risk of going lower, passing the subcutaneous tissue with the needle, to reach the muscle tissue and in this case the absorption of insulin will be accelerated with the risk of hypoglycemic crisis.
In fact, the blood flow differs a lot from one layer of the skin to the other:
-In the dermis, it is not very abundant and variable.
-In the subcutis, however, it is slow and stable and this is the privileged area for insulin injections.
-In the muscle, however, the flow is abundant, rapid and very variable; it is the optimal area in which to inject, for example, adrenaline in case of an acute allergy.
It is a barrier against invaders and hostile objects that could injure us, burn (cf burns) or freeze our bodies. Our skin is sturdy and resistant while remaining flexible and elastic. It expels heat when the temperature is too high and isolates us from the cold; warns us of external threats through its very sensitive nerve endings and hair. Moreover, at the skin level, vitamin D is activated (cfr calcio_vitamina D)

SKIN FUNCTIONS

Protecting acts as a barrier against traumas of various kinds through the elastic fibers contained in the collagen.
-Thermoregular, in fact in relation to the environmental temperature, the organism is able to regulate the capacity of the capillaries, in the sense that it can decrease or increase and the skin, so, retains or disperses the heat, increases or decreases the quantity of sweat.
- Feeling the stimuli through the receptors the pressure, thermal, pain stimuli; for example, pressure receptors are sensitive.
-Defend works as a barrier against chemical, bacterial or viral agents opposing their penetration with chemical defenses (eg pH), immunological and / or mechanical (sebum, sweating).
-Secret and synthesize eliminates waste and catabolites, synthesizes vitamin D.
- Representing the body image. it has an important function in our social relationships, because it represents the part of us that connects us with others.
- Act as a melan screen, ie the melanin content reacts to U.V. with the synthesis of melanin that defends us from the harmful effects of the same.
  

The skin consists of 3 main layers:

I'epidermis;
the dermis;
the subcutaneous tissue

The epidermis is the most external and superficial part of the skin. It consists of cells called keratinocytes, which are arranged one above the other in different sub-layers. The keratinocytes develop in the lower layer and then rise to the surface, where they are eliminated as dead cells. So, this layer is constantly renewed: the new cells support those deaths now inactive. Each layer has its specific structure and its specific function. The dermis consists mainly of connective tissue. It is responsible for skin flexibility and is involved in regulating body temperature. The dermis supplies the epidermis of nutrients through the vascular network. Contains sense organs for touch, pressure, pain and regulates body temperature. The dermis supplies the epidermis of nutrients by the vascular network and contains the sebaceous glands and hair follicles. Subcutaneous tissue (or subcutaneous tissue) forms the deepest part of the skin.
It consists essentially of adipose tissue. Its functions are multiple:
- to cover the bone structure;
- absorb shock (it is the case of the buttocks, when you start
walk on two feet);
- fix the epidermis and the dermis to the deepest structure of the body (bones and muscles);
- adjust the temperature changes;
- isolate the body when heat loss is a threat;
- cool the body when the heat becomes excessive and dangerous.

What is the thickness of the skin?

Thickness of the dermis and epidermis.
The epidermis has 5 thin layers and the dermis has 2, but the layers that determine the thickness are mainly 4:
the stratum corneum (epidermis);
the granular layer (epidermis);
the papillary dermis (dermis);
the reticular dermis (dermis).

The epidermis is the most external and superficial part of the skin. It consists of cells called keratinocytes, which are arranged one above the other in different sub-layers. The keratinocytes develop in the lower layer and then rise to the surface, where they are eliminated as dead cells. So, this layer is constantly renewed: the new cells support those deaths now inactive. Each layer has its specific structure and its specific function. The dermis consists mainly of connective tissue. It is responsible for skin flexibility and is involved in regulating body temperature. The dermis supplies the epidermis of nutrients through the vascular network. Contains sense organs for touch, pressure, pain and regulates body temperature. The dermis supplies the epidermis of nutrients by the vascular network and contains the sebaceous glands and hair follicles. Subcutaneous tissue (or subcutaneous tissue) forms the deepest part of the skin.

It consists essentially of adipose tissue. Its functions are multiple:
- to cover the bone structure;
- absorb shock (it is the case of the buttocks, when you start
walk on two feet);
- fix the epidermis and the dermis to the deepest structure of the body (bones and muscles);
- adjust the temperature changes;
- isolate the body when heat loss is a threat;
- cool the body when the heat becomes excessive and dangerous.
What is the thickness of the skin?
Thickness of the dermis and epidermis.
The epidermis has 5 thin layers and the dermis has 2, but the layers that determine the thickness are mainly 4:
the stratum corneum (epidermis);
the granular layer (epidermis);
the papillary dermis (dermis);
the reticular dermis (dermis).


In particular:
- to inject insulin into the subcutaneous tissue it is necessary to exceed an average length of only 2.02 mm;
- using a needle of appropriate length (4mm-6mm-8mm at most) and a correct technique, the injection of lnsulina is performed effectively and correctly;
The short needles currently available are the most suitable to avoid making mistakes and to reach only the subcutaneous tissue; moreover, recent studies show a preference for patients for the short needle, also due to the lower psychological impact on pain perception and no difference in glycemic control due to the use of long needles. On the contrary, with the long needle it has been seen that the blood sugar can oscillate fearfully and the absorption is fast if the dose is injected into the muscle, rather than into the subcutis. The ideal needles have a certification of compatibility, they do not lose insulin. When the doses are injected, the needle should remain in place at least 10 seconds after the syringe stub or the pen device button is pressed. Finally it is good to prefer the Thin Wall type needle, ie thin-walled because the insulin is injected more easily.

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