Evaluation of skin and subcutaneous tissue thickness at insulin injection sites in Indian, insulin naïve, type-2 diabetic adult population

CONTEXT: Skin thickness of type-2 diabetic insulin naïve adult patients. BACKGROUND: We have limited data on skin and subcutaneous tissue thickness of Indian type-2 diabetic population. Objective of this study was to assess skin and subcutaneous tissue thickness in insulin naïve type-2 diabetic patients as this information may be useful for insulin injection technique. AIMS: To assess the skin and subcutaneous tissue thickness at insulin injection sites in insulin naïve, type-2 diabetic adult population across different body mass index (BMI). SETTINGS AND DESIGN: Observational study carried out at our institute. MATERIALS AND METHODS: One hundred and one insulin naïve type-2 diabetic subjects underwent skin thickness measurement using ultrasound at insulin administration sites. Skin and subcutaneous tissue thickness were measured and prints taken. Though, the sample size to be taken for the study was not calculated, the results obtained clearly show that the power of the study was 80%. RESULTS: At arm and thigh, the mean skin thickness was more in males as compared to females in the BMI range <23 kg/m(2) (P < 0.05). At abdomen, skin thickness was more in males in the BMI range 19-23 kg/m(2) (P < 0.05). Across all the BMIs, mean skin plus subcutaneous thickness at arm was more in females (P < 0.05) except for BMI >25 kg/m(2) where thickness in males was comparable. At thigh, the skin plus subcutaneous tissue thickness was more in females (P < 0.05), across all BMI ranges. At abdomen, thickness was more in females for the BMI ranges 17-19 kg/m(2) and 23-25 kg/m(2), while it was comparable across all other BMI ranges (P > 0.05). CONCLUSIONS: Skin and subcutaneous tissue thickness can be estimated by BMI. In general it is higher in females.