I changed my 3-year-old dd's Novolog injection site from back of arms to thighs 3 weeks ago and have noticed a huge difference in her blood sugars--they're much more stable and easier to control. She has had horrible variation in her blood sugars for much of the time since diagnosis a year ago (like 300s to 60s daily and 400s to 40s more than once weekly!), though I've been able to keep her A1cs in the 6.8-7.1 range. Now I'm able to keep her bg measurements from upper 200s to 70s daily, with variation from 300s+ to 50s a few times weekly. So much better! I always have injected Lantus in her thighs. She has big problems with bottom injections, stemming, I think, from our unsuccessful trial with the pump. Her injection sites continually got inflamed, which hurt her and lead to very inconsistent insulin absorption, so I stopped pumping after 3 mo. I read about the difference in insulin metabolism when it's injected into muscle as opposed to subcutaneous fat, and it's metabolized more quickly in muscle, leading to lows post-injection followed by highs. My source said to watch for frequent bruising as a sign of intramuscular injection. And I know that my daughter is fairly thin, so the back of her arms doesn't have much fat. Anyway, it worked for me!
Yes, injection site can matter. Insulin injected into the muscle will peak faster, and not last as long. Also, insulin injected into an area that is near a muscle, can peak faster if the muscle is used, such as legs and running. Our ped endo wanted Lantus given in the buttocks due to a more stable action when given in that area.
We can't do them in the back of Sophie's arms,either. For some reason, that spot doesn't work as well for as her tummy does.
Maybe I'll try Lantus in the bottom again. She hates it, but I'm the grownup here ! Nice to know that others of you have found variability in insulin site absorption . . .
It really matters for me, too. Abdomen works best, and arms work well, too. I can't really do thighs, because I go low as soon as I walk anywhere. And buttocks have never worked for me - insulin just doesn't seem to absorb well there
I wish I had read this post before DD's morning injection! For the last month plus she has put up a big fuss about only doing injections in her arms...it is a control thing that I didn't have the energy to fight with her about. Last night we discussed the importance of moving around the injection sites. This morning we did the thigh. I hope she doesn't go low. Any suggestions on how I can encourage her to do her tummy? We have yet to get her to take a shot there...let alone the bum!
Well, for Sophie it was not being able to do them in her arms anymore. She just wasn't getting the results from her arms as she does with her tummy. I still have to get on her to move her sites around better, but it's a process. Now, she does her Levimer in her thighs, and occasionally in her bum, but not often. She has a hard time doing them and prefers to have that bit of control so I don't fight it too much.
Prior to going on the omnipod we had the same issue. We jokingly made up "butt day" but it worked. Every Saturday & Sunday was "butt day". Once we got off the arms/thighs and tried a new spot we were slowly able to get a rotation going. For DD it was fear and making a joke out of it really helped. We never did get her to use the tummy. They used the tummy as a learning site in the hospital and for whatever reason it is a no zone to this day
