For People with Diabetes: A Guide to Insulin Injection Sites

Starting insulin therapy can feel overwhelming at first. You might be wondering: Where and how should I inject insulin? What precautions should I take? And how can I manage insulin injections properly?

Of course, your doctor is your primary guide for insulin use, but here’s a helpful reminder of the key facts you need to know.

Main Insulin Injection Sites

There are four primary areas of the body where insulin is commonly injected: the abdomen, thighs, upper arms, and buttocks.  (1)

• Abdomen: This is the most convenient and effective site. You can choose any spot on the belly, but make sure it’s at least 5 cm (about two fingers) away from the belly button.
• Thighs: Use the front and outer part of the thigh only. Avoid the inner thigh and stay 3–4 fingers away from the knee and groin.
• Upper arms: Use the back of the upper arms where there is a fatty layer, at least 3–4 fingers above the elbow.
• Buttocks: Use the upper outer part of the buttocks for injection.

Why You Should Rotate Injection Sites Regularly

It’s essential to change your injection site regularly and avoid injecting into the same spot repeatedly. Repeated injections in one area can cause the skin to become hard or lumpy. This leads to two main issues: poor insulin absorption and unsightly skin changes. To avoid this, rotate the injection area every time. (2)

Example: If you injected insulin into the left side of your abdomen at breakfast yesterday, switch to the right side today. The next time you use the left side again, choose a slightly different spot within that area. Over time, the original site will have healed and can be used again.

Important Tips for Choosing an Injection Site

• Inject at least one finger-width away from your previous injection site. Try following a straight line for consistent tracking.
• If you inject more than once a day, use different areas for morning and evening doses.
• Do not inject into the muscle — insulin should go into the fatty layer just under the skin.
• Avoid injecting into damaged skin or areas with scars.
• Never inject into lumps or hardened skin.
• Never inject through clothing — this may contaminate the needle and increase the risk of infection. (3)

How to Inject Insulin Properly

Once you’ve chosen a suitable site, follow these key steps:

• Wash your hands and dry them thoroughly.
• Choose a clean, dry injection site.
• Attach a new needle to the insulin pen.
• If using a new pen, prime it by setting the dose to 2 units, holding it upright, and pressing the plunger until a drop appears at the needle tip.
• Dial the required number of insulin units as prescribed by your doctor.
• Insert the needle at a 90-degree angle and press the plunger until the dose counter reads zero.
• Hold for 10 seconds before removing the needle to ensure full insulin delivery.
• Detach the needle and dispose of it properly in a designated sharps container.

References

• AboutKidsHealth - Insulin injections: Selecting the injection site
• Diabetes - Injection Sites
• Healthify - Insulin injection sites
• Diabetes UK - Injecting insulin