A Case of Type 2 Diabetes Mellitus with a Giant Subcutaneous Hematoma Caused by Rough Insulin Injection

Abstract

We report a thin 70-year-old woman with type 2 diabetes mellitus and liver cirrhosis suffering from a giant subcutaneous hematoma caused by a badly administered insulin injection. She had watched a major league baseball player on television inject insulin directly without removing his uniform, i.e., directly through the cloth. Imitating him, she injected her abdomen without holding the skin taut, and soon felt pain at the injection site and dizziness. Three hours later, her consciousness declined and she was admitted. She was found upon examination to have severe anemia, wide-ranging subcutaneous bleeding, and a giant subcutaneous hematoma. We speculated that severe bleeding from the insulin injection may have been caused by her thinness and platelet loss due to liver cirrhosis and also due to using a Humacart ^®Kit, which had high infusion resistance as an insulin delivery device.
Although injecting insulin through the clothing may be reported as safe and convenient, patients who are thin and have complications such as liver cirrhosis should be carefully instructed about techniques and special attention required for insulin injections.