Location, Location, Location

Hello everyone… I don’t post much but just so frustrated tonight. I am currently on Tresiba and after 14 years of being on a pump so happy to be free from tubing. BUT I truly don’t know where to inject and get properly rotate my sites. If I inject into my stomach (lower abdomen under) I absorb like a champ. I literally run 65 - 125 pre and post meals without any other injections. I sail through the day completely stable. There are days I inject there and I am a little off or I eat too much but it’s manageable.

NOW I inject in any other area and it’s like a joke. I am high, multiple injections, lethargic … I’ve done love handles, upper gultes, thighs and it’s just awful yet I can’t keep using my stomach :(. Anyone else share similar things OR have suggestions for me??? Would love feedback.

I am fairly lean about 22% body fat and have ample fat but some areas like upper abs seem too lean for injection.

I don’t have much to add except we find the speed of absorption varies greatly from site to site. My DD needs to always use her stomach for rapid because otherwise, it takes well over an hour to begin working. We have tried thigh, calf, upper arm, hips etc. All much slower than the stomach. That said, she injects her tresiba in her thighs.

Unfortunately, the only way to figure out how to adjust your insulin rates for different areas is to inject in different areas. Add this to the list of things that suck about diabetes. We know more about administering insulin to ourselves than anyone in the world.

I would say be very incremental in dosage increases because our insulins are pretty potent. I would also suggest that you make sure to have the smallest syringe (with the smallest increments) if you are taking the insulin from a vial.

(I always mean to bring this up to my Endo but forget that I need the accuracy of a smaller syringe when I have to correct because of a bad set or site).

My advice won’t help much if you’re on pens and/or take a lot of insulin (relatively speaking).

Go to the outside of your shoulder. I use a short needle. Great absorption. Finding the outside of my shoulders is the best thing I have “discovered”. Great numbers.

Hit the outside of the shoulders !

Belly is by far the best site for rapid absorption me too.

What I do is belly-shoot most of my boluses, and put my basals in other places where absorption is not so rapid.

You might see if you can set up such a pattern too. That way if takes a few more units for anywhere other than the belly, you already have that habit down.

Repeating what was said above, sort of . . . but the reality is that this, like everything else about this insane disease, varies tremendously from person to person. For some, certain sites work great while for others, those same sites don’t. The only thing that matters is what works for you, and the only way to know that is to test and keep records.

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Everyone is different and everyone’s diabetes is different.

… and I’m just more different than everyone else! :laughing:


I’m having a hard time visualizing this location. Is this the top of the shoulder or the top of the arm? I’m feeling around on my shoulder and I’m not finding any good location on my body. Can you describe a little bit?

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My current infusion set it on the outside of my shoulder/top of my arm. I’ve used the area before and found that it works well, but the difference between good and painful site is very slight…

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The outside of my upper arms. Easy to reach. Great absorption. I also use the side of each thigh and of course each side of my lower torso.

Good luck.

I am very excited you are giving me hope! Just confirming this area?

Would that end up being an IM shot into your deltoid? If it were, that would explain why it would work a lot faster. Otherwise I’m not sure exactly what you mean either.

Deltoid, yes. I keep rotating spots, as well.

Rotating sites is one of the most overlooked management tools and one of the most important. In some of the replies I noted needle lengths being discussed and I agree that that could make a difference.
Have a plan for rotating, for example, I use all the possible areas on my right abdomen before moving to my left abdomen. I go from right to left using up all the surface area in each location before moving to the next. This can literally give you about a month of rest time for each area (I am using insulin pump therapy).
You could try moving sites keeping rate of absorptions in mind. For example, the stomach has been noted to be the fastest, use it up and then move to the next fastest which I believe is supposed to be the arms, then the thighs (mid to outer), then the hips. I have read that the absorption rate doesn’t really affect the action with insulins like Humalog, Novolog, or Lantus for instance.
As long as the abdomen has not been overused causing raised, hard, puncture resistant areas (hypertrophy) it makes sense that it would be the most stable. All the other sites are in movement, as compared to the abdomen that isn’t. The physical action in the arms, legs, hips may affect the absorption rate???
I am sorry, I tend to go on and on. One thing I have learned is that no matter how diligent you are with managing your diabetes your numbers will never be perfect. Paying attention improves your numbers for sure, but remember there are things beyond our control that can affect are BG.

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Right, so it might be particularly fast if you’re going into the muscle—insulin is usually injected into fat, which is slower absorption. Some folks find IM injections to be really helpful, but it could screw with someone if they weren’t expecting it to be faster.

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