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Site Selection & Site Rotation

Forum for Injection Technique (FIT) - Site Selection & Site RotationA s can help prevent problems at insulin injection sites.
FIT Site Selection Site Rotation Logo

Did you know?

Where you inject insulin matters.
The preferred areas to inject are:
  • abdomen
  • thighs
  • buttocks
FIT Site Selection Site Rotation 1
FIT Site Selection Site Rotation 2

The back of the arm may also be used but you may need help in order to reach the correct area.

Did you know?

A structured rotation pattern can help prevent problems at injection sites. Structured rotation means rotation between injection sites and within an injection site.
For example,

  1. Divide your abdomen injection area into 4 areas.
  2. Divide each area into smaller sections. Use only one section each week.
  3. Rotate within that section, in a circular pattern, with the next injection being 2-3cm from your last.
  4. Rotate to the next section the following week, etc.
FIT Site Selection Site Rotation 3
FIT Site Selection Site Rotation 4

Did you know?

Risk of lipohypertrophy, at your injection sites, is higher when you don't change injection sites often. Injecting into an area of lipohypertrophy may keep your insulin from working the way it should. That’s why it’s important to rotate properly and check your site before you inject.

Steps for site inspection:
  1. Stand up and feel the area
    where you normally inject.
  2. Look for puffiness, raised areas, redness, hardness or lumpiness.
  3. Discuss any concerns with your doctor or diabetes educator.

It’s all about keeping your injection sites healthy. Establish a routine and keep track!

FIT Site Selection Site Rotation 5

My Site Rotation Plan

There are many examples of how to rotate your injection sites. Your diabetes educator can assess your sites, or “real estate” to help you design a site rotation plan that will work best for you.
Download an example of an injection site rotation plan.

1 Vardar B, KIzilc S. Incidence of lipohypertrophy in diabetic patients and a study of influencing factors. Diabetes Res Clin Pract 2007; 77:231-236.
2 Johansson UB, et al. Impaired absorption of insulin aspart from lipohypertrophic injection sites. Diabetes Care 2005;28(8):2025-7.
3 Cureu B, et al. VDBD Guide: The injection in diabetes mellitus. (written in German), May 2011.
4 Bärtsch U, et al. Injectable therapy Pen Devices for treatment of diabetes (article in German). Ther Umsch 2006; 63: 398-404.
5 Patton SR, et al. Survey of Insulin Site Rotation in Youth With Type 1 Diabetes Mellitus. J Pediatr Health Care 2010; 24: 365-371.
6 Berard L at al. FIT Forum for Injection Technique Canada. Recommendations for Best Practice in Injection Technique. October 2011.

Supported by BD Medical – Diabetes Care
06-2013

About Forum for Injection Technique (FIT)

The Forum for Injection Technique (FIT) was developed to establish and promote best practice in injection technique for all involved in diabetes care.

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