Site Rotation

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Rotating where your child receives shots keeps her skin healthy and aids in predicting the speed of insulin absorption. Repeated shots in the same spot can cause fat deposits -- called lipohypertrophy -- that make the skin look lumpy. Injecting into sites showing evidence of lipohypertrophy can delay the absorption of insulin. Lipohypertrophy can usually be prevented by regular site rotation.

In general, insulin shots can be given pretty much wherever there's enough fat under the skin. The main areas are the abdomen, thighs, and the back of the upper arms. The abdomen is generally used the most. It's easy to reach and the insulin is absorbed from the abdomen at a more consistent rate from shot to shot. Site rotation is different for every person, but here are the basics.

Each injection site should be about the size of a quarter, so you only have to move about a finger-width away from your last shot each time you rotate. You and your child should devise a way to keep track of the site rotation.

Make certain that you don't inject too close to moles or scars.

Some people rotate only within a certain body area, like the abdomen. Others may use the abdomen for morning injections and the thigh or some other area for evening injections. Talk to the doctor or diabetes educator about the best options for your child.

If you inject in the arm, use only the outer back area of the upper arm (where the most fat is). Otherwise, you run the risk of injecting into a muscle. If you inject in the thigh, use only the top and the outside area. Stay away from the inner thighs-rubbing between the legs can make the injection site sore. If you inject in the abdomen, don't do it too near the navel. The tissue there is tougher and makes the insulin absorption less predictable.  Sometimes, your child can develop lipohypertrophy even if you rotate sites. If the skin around an injection site(s) begins to look lumpy, stop using that site and consult the doctor.