Site rotation

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How do I rotate injection sites?

You want to keep your skin free from lipohypertrophies (short: lipos) and any other anomalies. The easiest way to reach this goal is to rotate the injection sites within your preferred injection areas. Find out what this means for you and which options you have.

Protect your skin - rotate

Protect your skin – rotate

The target of site rotation is to never inject into the same spot within a short time. There are many ways to rotate and various assistive devices you can use. You first select your injection area which needs to have an adequate layer of fat; for example the abdomen, the thighs and the buttocks.(15) Within your preferred area, you follow a rotation scheme. Please remember that it is best to adhere to one scheme.

General rules

  • Never use the same injection spot more than once consecutively.
  • Place the injections 1-2 centimeters apart.
  • Never inject close to your navel.

Rotation schemes - an example

Rotation schemes – an example 

In cooperation with people affected by diabetes, our specialists have developed site rotation schemes for the generally favored injection areas: the abdomen and the thighs. If you operate with long and short acting insulin, you can combine these injection areas perfectly.

 

Abdomen

  • Start at either side of your navel.
  • Work your injections in a line from the top to the bottom of your abdomen.
  • Each day, you skip a little more (about 1-2 centimeters) away from your navel and start a new line.
  • Use the whole surface of your abdomen. Depending on your fat layer, the last line could start almost at your flank. 
  • Leave as much space as possible between the injection spots. The more spacious the surface of your abdomen is, the more generous you may place your injections.
  • When no more space is left to inject into, change to the other side of your navel and follow the same procedure.

Thighs

  • Start with your left leg.
  • Think of two lines down your thigh.
  • In the morning, inject into the outer line and in the evening inject into the inner line.
  • The next day, you move downwards to your knee and repeat the procedure.
  • Stay approximately handbreadth clear of your knees.
  • When you are done with one leg, proceed to the other one and repeat the procedure.

 

Rotation Schemes

Description Document Link
Rotation Scheme Abdomen Large
pdf (3.0 MB)
Rotation Scheme Abdomen Medium
pdf (3.0 MB)
Rotation Scheme Abdomen Small
pdf (2.5 MB)
Rotation Scheme Thighs
pdf (1.9 MB)

Tips

Tips: site rotation

✔ Rotate injection sites and injection areas to avoid lipos.

✔ Rotating is key to maintaining predictable blood glucose levels.

✔ Regularly check for lipos. If you detect any anomalies, please contact your physician. 

 

 

Sources

15. Hirsch L. et al., Intramuscular Risk at insulin Injection Sites-Measurement of the Distance from Skin to Muscle and Rationale for Shorter-Length Needles for Subcutaneous Insulin Therapy, Diabetes Technology & Therapeutics, December 2014;16(12):867-873.

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