I am T2 and preparing to start using insulin. Naturally I am doing all possible homework including reading Walsh, Bernstein, and everything else I can find on the subject (including these forums). But book learning won't tell you everything; nothing substitutes for real experience.

So my question today is about injection sites. Based on your experience, are some better than others? Do different ones produce more (or less) rapid effect? What other issues are there?

In fact: in general, what useful tricks (or "gotchas" to look out for) should I be alert to?

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The abdomen is reportedly the fastest absorption site. Of course, you want to inject into fat. If you hit muscle, onset will be very rapid. Also hurts like hell. The most important thing, which you've no doubt read repeatedly, is to rotate sites. Use all areas of your stomach, love handles, butt, legs & thighs. Get into the habit of rotating to avoid scar tissue.

As for method, a quick jab in, leave for 5-10 seconds & out. In case this is a concern, injections don't hurt. Pinching up skin doesn't work well, I think. Make sure you get short, thin needles, preferably with half unit markings on the syringe. The first syringe Rx I got was too large for me.

I don't shoot air into the vial & think this keeps insulin potent longer. Though not required, I keep insulin refigerated or in a Frio wallet. Believe it helps to keep it at a constant temp.

Thanks Gerry. Most of that reinforces what I have been reading and hearing. Definitely will need the short needles because I have been eating the Bernstein way and don't have much body fat these days. Enough, but certainly no surplus. So I might have to pinch a bit. We'll see -- practice makes perfect.

As for fear of needles, sharps don't bother me and never have, even when I was a kid. Something to be thankful for, anyway.

I have read that the abdomen is supposed to be quickest. I'm particularly interested in the experience of others on this point. I'd like to hear whether anyone's personal experience directly supports or contradict) this particular bit of conventional wisdom.

David,

Yep, my experience is that the abdominal area is the quickest, though rapid acting does act quickly regardless of where it's injected. I don't have much body fat either. You look slender in your pic.

Smaller doses act faster & more predictably than larger ones due to absorption rate. Agree with Dr. B that it's better to split large doses into two smaller ones. When ill, when high BG is particularly stubborn & larger dose is needed, I inject 1-2 units every hour or so rather than take a mega dose.

Glad you have no needle phobia.

Hi Gerri,

Thanx for the feedback. Yes, that is a very recent photo. I had just gotten my iPhone and was playing around with it. Taking my own picture seemed like a good test. :)

And yes, I agree emphatically with Bernstein about the "law of small numbers". As an engineer myself, I find that he and I generally think very much alike.

When using Mdi (now on the pump) I used to shoot correction boluses--due to a high bg--of novolog into my shoulder muscle directly for quicker reactions. This came from the bernstein book I believe and I found it effective when I wants a very quick reaction. Very little to no pain and I have little body fat the so it went straight into the muscle.

Abdo ok but at work I have short sleeve white shirts so I just inject into my upper arm (anywhere but not where the sergeant stripe go on the outer arm (can't reach this easily anyway but as Dr B says in his book it is where a nerve runs)). FInd arms easier as no small red dots on my white shirts if abdo site bleeds a bit! I put the basal doses in my butt - fill a syringe with the dose then reach round and inject (when I get up so not thru clothing tho I think Dr B injects through trousers??)

A couple of RKB videos which I found helpful...

Painless Insulin Injections

IM Insulin Video (for rapid corrections)

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