IM Injections Over Sub Q Shots/ or Pump Boluses


To start with, my son was not eager to try it, but, after talking about it for half a day, he just decided to do one and it went really easily. It is much less of an issue that one would believe.

He says it was painless.


I wondered if that was the case! He wasn’t sure if the amount would make a difference (thought it might just be a speed of action issue), but that’s good to know.

Haha, I’m a wimp enough about sub q injections! And have some trauma associated with poking muscles due to horrific testing I had done a few years ago when diagnosing my muscle disorder, so I’m not sure I could do it, regardless of pain. Maybe it would be just like when I started MDI, though - had my husband give me my first few shots until I sucked it up and tried it myself. :wink:


Very possible!

I should mention, though, that I am not sure about my son’s conclusion about the speed of the injection. It appeared to work too fast for it to be “real” – possibly he started dropping for some other reason. I would not trust that he will start going down right away as he described. We’ll keep on making tests and measuring how long it takes.


Interesting point. I wonder about that with my own corrections at times - considering my honeymoon-ing pancreas that sometimes decides to overcompensate for a high an hour or two after I notice it if I don’t correct it (so also coincides with an hour or two after I would give a correction in some cases), I’m not sure how much of my correction success is due to whatever I corrected with and how much is my own insulin.


but thats the point; it does work that fast. often w/in 1/2 hour you will see and immediate difference.


Was just going to say thanks for the advice from everyone but I’ll stick with Afrezza and my normal SubQ insulin when needed. So you read my mind!!!

Still cringing . . . LOL


I would believe 30 minutes – but he started dropping within 5 minutes, which is why I am suspecting another cause for that instance.


Your endocrinologist must love you! Ha! Hahahahaha! Ha.

On our recent “idiot maternity coverage endo” visit where EH presented his case for the OmniPod, the doctor stated that he preferred the MiniMed pump because he liked how the data was represented better. He wouldn’t suggest the OmniPod for anyone really. We pointed out that on MDI, the only data they get comes from us and our stories about having diabetes. But I love the thought of @Eric telling this jerk of a doc “Well, sir, I run two different OmniPods each week with various types on insulin, depending on the situation, and when I decided to try something else, I’ll do a little IM or hit it with some Afrezza.” (Yes, yes, I hear you @Eric, you don’t tell them anything and you forgot your testing kit at home. And I have no idea if @Eric does any of those things.)

I crack myself up with these funny diabetes related stories I tell myself!!!


I get so angry when reading these kinds of interactions with endos :frowning:

We all have enough to worry about as it is.


I’m curious. Does this doctor have diabetes? His comments are laughable. There are merits to both pumps but he should be open to what the patient wants. I would have literally laughed at him and asked kindly to try the OmniPod.


We need to remember the DOC doesn’t represent the average diabetic. I think majority of folks rely on Dr or NP,PA to manage their pump settings, at each appointment. They are Limited !!


have i mentioned that i finally found a new endo. remarkable on all accounts. now i can leave the old idiot endo in the dust :sunny: i am over the moon. this guy is perfection for me. :blush:


I have now tried 4 times, twice in my upper calf and twice in my quad. The ones in my quad worked fast. The ones in my calf did not seem to make an effect fast. Maybe I didn’t run enough on it? I just spent 2-3 minutes running up and down stairs.


that should have deffinately been enough. but i have never done one in my calf; you’d have to ask eric about that. i use my quad, too, and it works every time. maybe b/c of swimming that muscle is more effective. don’t know for certain.

after i inject, i flex my muscle for about 5 minutes. thats all though.


I wonder if it would be a good idea for FUD to get and post some guidelines from some MD/nurses re: best IM injection sites. I believe there are reasons to avoid a number of sites (potential problems with hitting nerves/blood vessels) that are more serious than potential concerns with sub-q, which is why specific sites (deltoids, certain regions of the gluteus, certain upper/side thigh muscles) are preferred and some discouraged. Might not be a big issue with the size of needle most folks are using for insulin compared to the larger ones for high volume injections, but would still potentially be a good idea to get that info from some reliable source(s). I’m planing to ask my endo next time I see him, but not sure when that will be yet.

I also wonder if muscle tissue type (such as slow vs fast twitch) might affect absorption—I think most of the sites most commonly used for IM injections are more slow twitch, as are the quads (vs the calves which are much more fast-twitch), but no idea how that affects it if at all.


when i discussed this with my endo last week, he recommended that i save the IM injections for higher BGs only (200 + ) and that i should just give myself a manual shot subq for corrections below that #. he told me about potential complications when over using the quad muscle, but i can’t for the life of me remember what it was. he felt that the subq shot wouldn’t work as fast as the IM, but b/c i wasn’t using my pump to deliver the insulin, i would still go lower faster and without complications.

i will have to look into this further.


I think if you use the same spot over and over it becomes a problem. But you aren’t doing IM as much as you might be doing a pump bolus. So I don’t think it’s really too big of a concern, as long as you rotate. You have muscles on your arms too! Use those!

Did he give specifics on this? Is it because of the infusion depth of your pump that he said a subcu shot would be faster?


Here is a link to helpful information from Gary Scheiner

IM injections / Diatribe / Scheiner

“1. Put some insulin in your muscle.
No, it’s not a dyslexic typo. Injecting insulin into muscle makes it work faster. Much faster. From my experience analyzing data from continuous glucose monitors, insulin injected into muscle peaks and finishes working twice as fast as insulin injected into the fatty later below the skin. It doesn’t work harder, just faster. Good sites to inject include the forearm, triceps, calf and quadriceps.”


no. he said that the infusion site is not as sensitive to insulin b/c the site has been being used for over a period of time, and that a sub q shot would be in a “clean” area. ( i think this is what he meant; but as i said before, i can’t totally remember the hows and the whys) sorry if i am being unclear.


That makes sense. Kind of like we discussed how day 1 of an infusion can work better than day 3.