Skin and subcutaneous thickness at injecting sites in children with diabetes: ultrasound findings and recommendations for giving injection

Pediatric Diabetes, 05/17/2012

Presti DL et al. – It seems medically appropriate for all children to use short needles where possible to minimize inadvertent IM injections which may increase glycemic variability.


  • One hundred one children with type 1 diabetes were divided into three groups according to age: 2–6, 7–13, and 14–17 yr.
  • The thickness of skin and subcutaneous (SC) tissue was measured by ultrasound in all injection sites.


  • Skin thickness varied from 1.58mm in the arm of the youngest children to 2.29mm in the buttocks of the adolescents.
  • Values decreased progressively based on age (2–6 < 7–13 < 14–17) and on body site (arm < thigh < abdomen < buttocks).
  • Skin + SC thickness varied in a similar fashion.
  • The skin surface to muscle distances were <4mm in nearly 10% of children, especially in the 2–6 yr group.
  • This rate of IM injections doubles when using the 5–mm needle, and when injections are given under similar conditions it triples using the 6–mm needle.

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