Aim: Insulin glargine is a long-acting insulin analogue with favourable clinical characteristics. We studied a slim 24-year-old female with Type 1 diabetes who repeatedly experienced severe hypoglycaemia after switching from NPH insulin to insulin glargine at identical daily doses.
Methods: Clinical examination and high-resolution ultrasound.
Results: The patient frequently placed her injections into muscle tissue, followed by unexpected rapid insulin action. After correction of her injection technique, hypoglycaemia did not recur.
Conclusions: The long-acting kinetics of insulin glargine require precipitation in the subcutaneous tissue. Therefore, each patient's injection technique should be carefully checked when treatment with insulin glargine is initiated, particularly in young and lean individuals.