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From Chandigarh,U.T., India:

I am giving my 11 year old son three injections daily, and presently I am selecting the sites at random (abdomen for his pre- breakfast dose, thigh for his pre-lunch dose and upper arm for pre-dinner, etc.) Does choosing sites this way affect blood sugar control? What is the best possible way to change insulin injection sites? Would it be more appropriate to give all the three injections at any one site by rotation for about a fortnight and then shift to new place?


I really think you are correct in saying that injection site selection is very important for blood sugar control and choosing them randomly is not the best way. These are my rules:

  1. abdomen -- (consider that the area above the umbilicus line because the insulin absorption is a little bit faster) for the pre-meal injections, rotating only inside the abdominal area
  2. arm -- for pre-meal injections only if blood sugar levels before the meal is in the lower ranges
  3. buttock -- for the bedtime NPH only;
  4. thigh -- for extra shots of regular/analog to control spotted highs


[Editor's comment: Obviously, there could be a lot of ways to set up guidelines for where to give shots. There are some general guidelines, such as: don't inject into an area that will be used for vigorous exercise; "belly is best"; and "stay in the same zone" (thigh, arm, buttock, belly). But the writer makes an important point: randomly choosing is not appropriate, as absorption may vary from one time to the next. WWQ]

Original posting 20 May 2002
Posted to Blood Tests and Insulin Injections


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