Where do I give my injections and the importance of rotating your insulin injection sites?

Insulin injection/pump site rotation is an extremely important part of diabetes care.

Site rotation helps prevent lumps from forming under the skin and ensure your insulin will be absorbed well into your body. If insulin is injected into the same spot repeatedly, fatty lumps will form. This is called Lipohypertrophy and means that insulin will not be absorbed in the same way as in healthy tissue. This can lead to a need to increase insulin doses and greater variation in blood glucose levels (BGL).

To help prevent lipohypertrophy, it is important to rotate your injection sites.

Suitable injection sites include: 

• stomach
• hips
• the middle part of the upper arms
• the upper outer thighs

• If your child has little or no fat tissue in the stomach area please do not use this area
• Exercise increases insulin absorption so the arms and legs may need to be avoided on days when young people are very active with sport
• If you are unsure where you should inject your child or if they have any changes to their skin, please contact your diabetes educator
• If you suspect an area of your child's body has lipohypertrophy, it is important to use the other sites as indicated above and avoid this site for injections.
  Lipohypertrophy can take a few months to heal. Ask your diabetes doctor or diabetes educator to have a look at this area at your next outpatient clinic appointment. 

Below are examples of rotation strategies for the stomach area. Similar rotation can be used for the arms, legs and hips as well

Storage of insulin

• Open insulin needs to be stored in a dry cool place and can be used for up to a month after opening. If your child is on small doses of insulin, label the pen/cartridge when you take it out of the packaging. 
  
• Unused insulin must be stored in the fridge. It must not be frozen. Insulin is destroyed if frozen. 
• Leaving the insulin penfill or cartridge exposed to sunlight or extreme heat/cold e.g. insulin left inside a hot car can destroy the insulin. If your insulin is exposed to these conditions, discard it and start a new insulin penfill / cartridge 
• For times that insulin may be exposed to extreme temperatures, a storage wallet can be used to keep insulin at the safely required temperature.

Last updated March 2023