Model Study of the Pressure Build-Up during Subcutaneous Injection
Open accessAbstract
In this study we estimate the subcutaneous tissue counter pressure during drug infusion from a series of injections of insulin in type 2 diabetic patients using a non-invasive method. We construct a model for the pressure evolution in subcutaneous tissue based on mass continuity and the flow laws of a porous medium. For equivalent injection forces we measure the change in the infusion rate between injections in air at atmospheric pressure and in tissue. From a best fit with our model, we then determine the flow permeability as well as the bulk modulus of the tissue, estimated to be of the order 10-11-10-10 m2 and 105 Pa, respectively. The permeability is in good agreement with reported values for adipose porcine tissue. We suggest our model as a general way to estimate the pressure build-up in tissue during subcutaneous injection.
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Insulin may flow into the connective tissue septa that surround the adipose cells, remain within the surrounding layer of inflammatory tissue, and/or flow upward along the cannula shaft onto the skin surface.
“Insulin may flow into the connective tissue septa that surround the adipose cells, remain within the surrounding layer of inflammatory tissue, and/or flow upward along the cannula shaft onto the skin surface.30,31”
From Detailed Analysis of Insulin Absorption Variability and the Tissue Response to Continuous Subcutaneous Insulin Infusion Catheter Implantation in Swine (2017) · cites this paper as [30]
The Results (page not available) say injected insulin distributes between fat lobules, and the Introduction describes connective tissue separating those lobules. The Discussion mentions back-flow through the injection channel. The paper does not describe insulin remaining in a surrounding layer of inflammatory tissue or flowing along a cannula shaft onto the skin surface. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSlow increases and abrupt decreases in insulin pump back pressure suggest that a bolus dose of insulin may accumulate within the layer of inflammatory tissue, distend the tissue, and then abruptly travel into adjacent tissue through a pathway with lower resistance.
“Slow increases and abrupt decreases in insulin pump back pressure suggest that a bolus dose of insulin may accumulate within the layer of inflammatory tissue, distend the tissue, and then abruptly travel into adjacent tissue through a pathway with lower resistance.30”
From Detailed Analysis of Insulin Absorption Variability and the Tissue Response to Continuous Subcutaneous Insulin Infusion Catheter Implantation in Swine (2017) · cites this paper as [30]
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Research works printed but not linked: 21
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Cited by
Sorted by citations
Doughty, D. V., Clawson, C. Z., Lambert, W., & Subramony, J. A. (2016) · Journal of Pharmaceutical Sciences · doi:10.1016/j.xphs.2016.04.009 · Cited by 74 · see citing works
Hauzenberger, J. R., Hipszer, B. R., Loeum, C., McCue, P. A., DeStefano, M., Torjman, M. C., Kaner, M. T., Dinesen, A. R., Chervoneva, I., Pieber, T. R., et al. (2017) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2017.0175 · Cited by 39 · see citing works
“Insulin may flow into the connective tissue septa that surround the adipose cells, remain within the surrounding layer of inflammatory tissue, and/or flow upward along the cannula shaft onto the skin surface.(30,31) We hypothesize that a layer of inflammatory tissue that is thick, dense, and/or continuous may prevent…”
Background
- Authors
- Thomsen, M., Hernandez-Garcia, A., Mathiesen, J., Poulsen, M., Sørensen, D. N., Tarnow, L., & Feidenhans'l, R.
- Affiliations
- University of Copenhagen (DK)
- Novo Nordisk (Denmark) (DK)
- Steno Diabetes Centers (DK)
- Corresponding author
- Thomsen, Maria
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-08-14
- Volume
- 9
- Issue
- 8
- Pages
- e104054
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4133188
- OpenAlex
- W1993873316
- Cited by
- 65
- References
- 0
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 11 · 2023: 10 · 2022: 6 · 2021: 12 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 5 · 2016: 2
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Villum Fonden (00007172)
- Novo Nordisk
- Topics
- Health Sciences › Medicine › Emergency Medicine › Intramuscular injections and effects
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Physical Sciences › Engineering › Biomedical Engineering › Intravenous Infusion Technology and Safety
- Keywords
- subcutaneous injection, pressure buildup, insulin infusion, type 2 diabetes, subcutaneous tissue, porous media flow, tissue permeability, bulk modulus, mass continuity, infusion rate, adipose tissue
- MeSH terms
- Adipose Tissue, Animals, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Injections, Subcutaneous, Insulin, Male, Permeability, Pressure, Swine, Subcutaneous Tissue, Subcutaneous Fat
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