Insulin Injection Sites

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Insulin should be injected into the fatty tissue just below your skin. If you inject the insulin deeper into muscle, your body will absorb it too quickly. This can lead to dangerously low blood glucose levels.(Hypoglycaemia)

People who take insulin daily need to rotate their injection sites. This is important because using the same spot over time can cause lipodystrophy. In this condition, fat either breaks down or builds up under the skin. Lipodystrophy causes lumps or indentations that interfere with or cause erratic insulin absorption.

You can rotate to different areas within the same site, keeping injection sites about an inch apart. Generally, you can inject anywhere that there is enough fat under the skin. Absorption rates may vary depending on the injection site.

 

Abdomen

Many people prefer to inject insulin in the abdomen. Insulin is absorbed more quickly and predictably there. This part of your body is also easy to reach. Select a site between the bottom of your ribs and your pubic area, steering clear of the area surrounding your navel. Generally, don’t inject within two inches of the belly button.

You’ll want to avoid areas around scars, moles, or skin blemishes. They can interfere with the way your body absorbs insulin. Also stay clear of broken blood vessels and varicose veins.

Thigh

Inject into the top and outer areas of your thigh, about 4 inches down from the top of your leg and 4 inches up from your knee.

Arm

Use the fatty area on the back of your arm, between your shoulder and elbow.

Buttocks

The upper, padded area of the buttocks is an often-used spot. Don’t inject the part of the buttocks you sit on. Instead, aim higher, where the back pockets of pants are normally found.

1.Same Time, Same General Location

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Insulin is absorbed at different speeds depending on where you inject, so it’s best to consistently use the same part of the body for each of your daily injections. For example, do not inject your lunch bolus dose in the abdomen on Sunday and in the thigh on Monday. If you have picked the thigh for your evening injection, then continue to use the thigh for all of your evening injections.

Most insulin enters the blood:

Fastest from the abdomen (stomach)

A little slower from the arms

Even slower from the legs

Slowest from the buttocks

Unless your doctor has told you otherwise, it is a good idea to inject your breakfast and lunch bolus doses into the abdomen. Insulin is absorbed fastest when injected into this area. Fast absorption is needed at mealtimes to cover the carbohydrates you are about to eat.

On the other hand, your supper or bedtime dose of long-acting insulin could be injected into the thigh, buttocks, or upper arm. That’s because you want the long-acting insulin to take effect gradually and cover your needs throughout the night.

If you mix two types of insulin in one shot, you can inject into the abdomen, arm, thigh, or buttocks.

2.Rotate Within an Injection Site

To avoid developing hard lumps and fat deposits, it is important to inject in different spots within a general part of the body.

1.Change sides within an area. For example, if you inject your evening insulin in the thigh, try using the right thigh one evening, and the left thigh the next evening.

2.You might find it useful to picture the face of a clock on your abdomen. That helps you to keep each of your injections at least one finger’s width from the last injection.Let’s say that you inject four times a day, and all of the injections are in your abdomen. Look down at your abdomen and picture “Noon” below your belly button. Place your first injection at Noon, your second injection at 1 o’clock, the third injection at 2 o’clock, and the fourth injection at 3 o’clock. You will not come back to the “Noon” spot again until day 4, which gives that spot a chance to rest.

 

3. Tips for Site Rotation

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Work with your doctor and track your blood glucose levels carefully when you begin practicing site rotation. Over time, you and your doctor will learn which injection sites give you the best blood glucose control at different times of day.

1.Do not inject close to the belly button. The tissue there is tougher, so the insulin absorption will not be as consistent.

2.For the same reason, do not inject close to moles or scars

3.If you inject in the upper arm, use only the outer back area (where the most fat is). It is hard to pinch the upper arm when you are injecting yourself. Try pressing your upper arm against a wall or door.

4.If you inject in the thigh, stay away from the inner thighs. If your thighs rub together when you walk, if might make the injection site sore.

5.Do not inject in an area that will be exercised soon. Exercising increases blood flow, which causes long-acting insulin to be absorbed at a rate that’s faster than you need.

6.It might seem easier to find a spot that does not hurt and inject there all of the time. However, the result could be unpleasant swelling and lumps.

7.You can reduce injection pain by choosing a needle length that is right for you.

8.Move to a new injection site every week or two.

a.Inject in the same area of the body, making sure to move around within that area with each injection, for one or two weeks.

b.Then move to another area of your body and repeat the process.

c.Use the same area for at least a week to avoid extreme blood sugar variations.

d.Rotate the sides (right, left) of your body where you inject within your injection sites.

 

4.Bleeding at the Injection Site

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It’s normal for a small amount of blood to occasionally appear when you inject insulin. This bleeding, which is usually caused when the syringe punctures a tiny blood vessel, can be stopped by putting pressure on the injection site with your finger or a cotton ball.

Also, be sure that you:

Don’t rub the spot.

Maintain light pressure with your finger to prevent bruising.

If a bruise does appear, don’t use that injection site again until the bruise is gone.

If you frequently bleed when you inject, you’re probably injecting incorrectly, or you may have a medical problem. Consult your healthcare professional if you find that you’re bleeding frequently.

 

5.Skin Problems at Injection Sites

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Skin irregularities can sometimes occur at injection sites due to changes in the subcutaneous fat, of which there are three types.

1.Fat hypertrophy (also known as  “insulin hypertrophy”) appears as soft, often “grape-like” lumps under the skin at the injection sites.

This unusual condition may be caused in some people by the natural effects of insulin (one of which is to cause fat to grow) or by reuse of needles. To prevent the further development of hypertrophy, rotate injection sites and don’t reuse needles.

2.Fat atrophy (also known as “lipoatrophy”) is a loss of fat under the skin’s surface. This rare condition appears as a dip in the skin and has a firm texture. It occurs much more commonly with impure insulins.

3.Scarring of the fat (also known as “lipodystrophy”) is caused when you inject too many times into the same site or when you reuse a needle. To prevent lipodystrophy:

a.Rotate your injection sites
b.Rotate where you inject within your injection sites
c.Rotate the sides (right, left) of your body where you inject within your injection sites
d.Always using a new syringe or pen needle with each injection

Some people find that it’s less painful to inject into their lumps (often referred to as “lipos”) than it does to inject into healthy tissue. Even though it’s tempting, you should never inject into lipos because insulin doesn’t absorb well there.

Lipos are often easier to feel than to see, so check your injection sites with your fingers frequently. If any unusual growths, textures, bumps, or indentations have formed, switch to another site and let your healthcare professional know about them.

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