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[IP] Insulin absorption and injection sites

The following information can be found at
www.diabetes.org/clinical practice recommendations 2001:

"Injection site
Insulin may be injected into the subcutaneous tissue of the
upper arm, the anterior and lateral aspects of the thigh,
the buttocks, and the abdomen (with the exception of a
circle with a 2-inch radius around the navel). Intramuscular
injection is not recommended for routine injections.
Rotation of the injection site is important to prevent
lipohypertrophy or lipoatrophy. Rotating within one area is
recommended (e.g., rotating injections systematically within
the abdomen) rather than rotating to a different area with
each injection. This practice may decrease variability in
absorption from day to day.

Site selection should take into consideration the variable
absorption between sites. The abdomen has the fastest rate
of absorption, followed by the arms, thighs, and buttocks.
Exercise increases the rate of absorption from injection
sites, probably by increasing blood flow to the skin and
perhaps also by local actions. Areas of lipohypertrophy
usually show slower absorption. The rate of absorption also
differs between subcutaneous and intramuscular sites. The
latter is usually faster and, although not recommended for
routine use, can be given under other circumstances (e.g.,
diabetic ketoacidosis or dehydration)."

Repeated overuse of any site can lead to poor absorption of
insulin. Poor absorption = slower response and higher BGs.
This applies to infused insulin, as well as injected insulin
into subcutaneous (fat layer under the skin) sites.

As always, YMMV.

Barbara A. Bradley, MS, RN, CDE
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