HELP with Shots


I need some advice. My 6 year old daughter was diagnosed with type 1 last May and we have doing ok with the shots but lately she crying when we give a shot in the Butt area. We were only doing arms, stomach and sides because her legs hurt really bad. The last time we visited the doctor they said to try and Rotate the shot as her arms have some fat buildup. Its not like there a lumps in the are but the back of her arms seem to have a large area of fat from top of the arm down to the elbow. Because of this were trying the butt.

So my question is are there better methods of shots to make them painless...and really is the arms, stomach and sides not enough rotations? We move up and down each area so its at least an inch away each day.

Hmm, I have been pumping for a couple of years and was 120 lbs @ dx but I always found my legs the most comfortable but used my abdomen pretty much exclusively, as the insulin seemed to get absorbed more smoothly there? I was always pretty much stick it and if it didn't feel good I'd stick it somewhere that felt better but I'm not sure a 6 year old would be able to be 'in charge' like that or you could be there all day?

Thankyou for the concern is we rotate to a different part of the body for every shot within a day. Then we move at least 2 or 3 inches away from the spot where we shot the night before....why would that cause issues with the fat build up. Could the fat on the back of arms be just normal growth?

I am not sure about the fat build up deal, I didn't run into that, except for a giant beer gut (long's mostly gone now...). I think my inclination was to go as close to the prior shot as possible, to leave time for the other 'real estate' to get really healed? It's easier to find the shot you just did if you are shooting at it so you do a few in the same area and then move?

I'm assuming that her needles are super short & thin. I don't feel injections at all. Do you use a pen or syringes? I found pens hurt & I had awful bruising. Outer thighs & tops of thighs work well. Anywhere there's fat is fine. I use the top of my butt because that's all I can reach:)

Oh, I forgot about that, I went to some lengths to get the longer needles as I convinced myself (without any scientific studies...) that the longer ones were 'better' so anything I suggested might be influenced by that too?

Think her doc meant scar tissue, which is a problem, of course. -

please try this website ...a gadget placed every 3 days into the body for insulin usage , instead of the daily needle shots ...would this solve some of the problems with your little one ?

I did not check your profile ...I believe the port is available in the US.

Problem with an i-port is that it uses the same site for multiple injections so there's a greater chance of developing scar tissue.

yeah she did not say scare tissue...she said it fatty. If you rub your hand on the back of her arm there are not lumpy areas...its all on smooth just fatter now. Of course she is skin,muscle and bone so its easy to tell.

I thought Mom was mostly referring to the pain the needle causes and in answer to that particular question the suggestion i-port was made .I don't appear to have scar tissue and been needling a long time , including

rotation .

Glad it's not scar tissue. Wonder why she'd be concerned about injecting into fatty tissue on arms. We're told to rotate to avoid getting scar tissue in favorite sites we prefer to use, but it's not that injecting makes an area fatty. Good that your daughter is a trooper about injections in general. So hard on little kids:( I've only used my arms a few times because it hurt. But, it's hard to inject there yourself & pinch of skin to avoid muscle. A lot easier for someone else to do this. Do you think you may have accidentally injected into muscle in her butt? It's the largest muscle in the body.

I wouldn't worry about the arms since she is newly diagnosed and her arms should be OK. I have been shooting for 40 years, and at this point I have tried everything. I like the thighs, arms and stomach. The botoom line is that eventually, some areas are going to become sensitive. The pain could also come from the insulin itself. Is she using Lentus? This insulin stings.

It is a bit strange that your daughter would develop lipohypertrophy (the fat buildup) so soon. Lipohypertrophy can result in slowed insulin absorption, leading to larger injections and even more lipohypertrophy. I beleive the best guidance is to rotate injection sites with the idea that the fat buildup will be absorbed back into the body over time. Personally, I would not rotate on the same limb, I would rotate around the limbs before returning. And I don't think you have to use "all possible" injection sites, and if the butt hurts, why not simply remove it from the rotation. I do think you should examine injection technique. With proper needle selection and technique, shots should be really pretty pain free. With a child, you may want to take special care to pinch up properly, if you miss the subcutaneous layer that can hurt and doing that on the arm or leg or butt can be tricky. I've never been able to pinch properly on my arm or butt. You might check out some of the thinner and shorter pen needles that are available now such as the BD ultra fine nano, 32G, 4mm.

I think your current program is adequate without the butt or legs. I'll echo the sentiments that I think it's maybe too early to completely abandon the arm if that is a preferable spot? Perhaps just use them less often than now? Hopefully, as she grows, you'll have more real-estate to work with and it will be less of an issue!

We too have been going through something similar: My 2.5 yr old was told back in Aug during a hospital stay that we were to stop using her arms for at least 6 months. Her arms were looking like they were "building up" was the term the endo used and they wanted to avoid them for awhile. At the time we had not been doing an injections in the abdomen because she freaked out, but have worked to add in one per day. She gets all nervous and upset about an abdomen shot, but once she gets it she gets over it really quick so we don't think it hurts anymore than the others. We still rarely do any in the Butt area, b/c she always cries and says they hurt. Her crying will go on and on so I do tend to believe her on these. I don't have a better answer to your questions. Just a note to say we too are going thru the same thing. Good Luck!


After doing a bit of " research " by going to your page rpwills ...Mom should read Dad and you are aware of the i-port :)


I was diagnosed with type 1 diabetes at 5 years of age and I remember when my parents changed injection sites they became more painful.My parents used to numb my injection site before injecting and this reduced the pain.Also if ye are injecting everywhere accept the butt I cant see why this is a problem.Your daughter is very brave and I wish ye all the best of luck!It will get better!

I agree about developing lipohypertrophy so soon especially with the described rotation schedule. Usually with lipohypertrophy (which I assume is what the Endo is concerned with?) you would see "knots" and it would not be smooth as suggested. I know on my kids they often go through growth spurts where more fat is built up followed by growing taller. Maybe this is the cause for the extra fat?

I usually shoot in the stomach. Just rotate around. Sometimes back of arms or top of thighs, but never in the butt.