Where Can I Find New Insertion Sites?
I’ve had type 1 diabetes for 28 years and have used a pump for 14 years. I have
trouble ;nding enough good infusion set insertion sites. I primarily stick to my
stomach. What other sites could I use?
Wes Barnes, Cary, N.C
Christy L. Parkin, MSN, RN,
CDE, responds: A;er years of
pump therapy and/or injections,
it can be a challenge to ;nd
choice “real estate” that o;ers
good insulin absorption.
when the thighs rub against each other, the site
can become irritated and at risk for infection.
; Back of the arms. You may have some extra
tissue under the skin here, but the area is hard
to reach, especially if two hands are required
for insertion. Physical activity can increase the
absorption from this location.
SI TE RO TATION
What to Know: The abdomen is the preferred
site for infusion set sites and injections. It is
easy to see and reach, and o;ers the quickest
absorption. Alternate sites tend to absorb
insulin more slowly than the abdomen. Here
are alternate sites:
; Hips and upper buttocks. Even lean people
tend to have some extra padding in these
spots. Although there is slower absorption
here, these areas are good sites for people
with low body fat.
; Outer thighs. Absorption may be increased
with activity, such as walking or running. The
inner thighs aren’t recommended because
Possible Solutions: Inserting too many
infusion sets in the same spot over many years
can lead to scarring and/or overgrowth of fatty
tissue (known as lipohypertrophy), which can
cause poor absorption of insulin. Poor
absorption may delay the e;ect of the insulin
or require you to use more. If you can feel or
suspect damaged tissue under your skin, avoid
using the area; it can take several months for
the tissue to heal.
Make a plan to regularly use di;erent sites
to maintain good skin integrity. Site rotation is
a systematic method of selecting various sites
so that each one has a chance to fully heal
before it is used again. There are several
methods of site rotation (right). Choose the
method that works best for you.
New sites should be at least 2;inches away
from a previous site (as well as 2;inches
away from the belly button). Change your site
every two or three days, depending on the
type of cannula you use.
INJEC TION AND INSERTION SITES
Takeaways: Experiment with some alternate
locations to open up your options and keep
your sites healthy. And change the infusion
set at the ;rst sign of pain, swelling, or redness
to avoid tissue damage. Remember, the rule
of thumb to live by to preserve your sites is:
“When in doubt, change it out.”
Evgeniy Ivanov/Getty Images (body); Elenaleonova/Getty Images (torso)
Imagine patterns on
your abdomen, and
choose a new site that’s
at least 2 inches from
the previous one.