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Pediatric Endocrinology

Resources for Managing Diabetes - Injection Site Rotation

Moving the place you give your shots is called site rotation. Rotating sites means following a regular pattern as you move your shots from site to site. This is important in order to avoid a build-up of fatty tissue which can occur when shots are always given in the same place. Fatty tissue build-up can change how quickly insulin is absorbed from the skin, which may in turn affect blood sugar levels.

Appropriate sites for injection are:

• Outer area of upper arm
• Abdomen (stay at least one inch from the belly button)
• Upper, outer area of buttock
• Top and sides of the thigh

Insulin enters the blood:

• Quickest from the abdomen
• A little slower from the arms
• Even more slowly from the legs
• Most slowly from the buttocks

Try to use one area of the body consistently for your morning shot and another are for your evening shot. Many people find it easier to use their legs in the morning before they get dressed and to save their arms and abdomen for their evening shots.

Changes in daily routine or blood sugar levels may require a change in your rotation pattern.

• Avoid injecting into an area that you will use during exercise if exercise will occur right after your shot. Exercise causes insulin to enter the blood quicker and can lead to low blood sugar.
• Use a quick absorbing site like your abdomen or your arm when your blood sugar is very high.

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