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Kos Diabetes Group: Injection Site Rotation [1]

['This Content Is Not Subject To Review Daily Kos Staff Prior To Publication.']

Date: 2023-09-15

This diary is mostly for Type 1 diabetics and Type 2 insulin dependent diabetics. If you need one or more daily insulin injections to control your diabetes, it is important to not always inject in the same place.

We all know the health reasons behind using sterile lancets and injection needles for insulin, but does it matter where on your body you inject? The answer is yes. Where you inject your insulin and how often you inject it there can have some considerable impacts on the rate of insulin absorption and changes in skin texture around the injection site. The best way to avoid complications from over-injecting in the same place is to constantly change where you inject and use a system of injection site rotation.

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The most visible symptom of not rotating injection sites is the development of lipohypertrophy. This is a build-up of fatty tissue which can occur when shots are always given in the same place. You will be able to feel this firm bump under your skin. It may also become large and quite visible. Injecting into this fatty tissue build-up can slow the absorption of insulin into your blood stream by as much as 25%. I could not find any free to use pictures of this condition. Google it and look at the images.

Another side effect is liposatrophy, where the fat beneath the skin’s surface becomes depleted and can give a dimpled appearance. While these two conditions (collectively known as lypodystrophy) are not life threatening, they can result in less stable blood glucose levels since an increase of insulin resistance can occur at the injection site and may require higher doses of insulin over time.

Plan ahead for your insulin injection rotation. When possible, keep each of your daily injections to the same region and rotate around that area. For instance, if your morning is placed in the abdomen on Tuesday on your left side, then your morning injection for Wednesday should be on the right side of your belly – not in your arm.

Take it a step further and map out your injection sites. Since most people inject into the abdomen, it’s a good example to use. You can divide your belly in 4 quadrants and divide those areas into even smaller areas, rotating in each part in a circular method keeping each injection 2 – 3 cm from your last injection and being careful to avoid any scars or the area near your belly button. Move on to injecting in another quadrant the following week. This same mapping technique can be used on other injection areas like thighs or upper arms. You can keep track of this in a journal to document where you last injected along with the dose and type of insulin. Keeping a routine for rotating your insulin injection sites can prevent complications and help keep your blood sugar levels more consistent over time, making living with diabetes a little bit easier.

Where you inject also matters because different parts of your body intake the insulin differently. The most sensitive and fast absorbing area is your stomach and the rate of insulin uptake decreases in the arms, then legs, and buttocks. When you are injecting for fast acting or slow release insulin you’ll want to take this into consideration. If you need an insulin dose before you hit the gym or take that evening jog, it is best to avoid injecting in the arm or thigh as the increase in blood flow to those areas can speed up the insulin absorption. Testing post-insulin injection will help you to understand more accurately how your activity level and the injection site used affects your blood glucose levels.

As always, please review any plan or change with your doctor.

Just a note: I will be out of town next week to visit my family in Ohio. There may or may not be a diary next Friday depending on how organized I am before I leave.

Lynne

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[1] Url: https://www.dailykos.com/stories/2023/9/15/2193315/-Kos-Diabetes-Group-Injection-Site-Rotation

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