Bolus injection site advice please

[Proud to be erratic]

Yesterday I had a scheduled repair of an incisional hernia on my abdomen and I emerged from a general anaesthetic to find I was unexpectedly wearing a very wide supporting belt or girdle, tightly holding my repair in place. But denying me any access to my normal bolus injection sites across my abdomen.

Inevitably my BG was elevated and at 3am I took a correction, hoping to restore some degree of normality by this morning, alas to no avail; Libre shows it did very little. I used an injection site below the girdle at the top of my groin, but I think the correction didn't work because the whole region is so compressed by the girdle (it could also be because I perhaps needed to strengthen my correction ratio for these unusual circumstances).

I don't want to remove the girdle just yet; I'm coughing a lot because of the tube that was put down my throat, and the coughing 'racks' my abdomen, so I want to take every reasonable measure to prevent a recurrence of this or any other hernia! The girdle definitely helps mitigate that possibility.

Where else could I inject my bolus and would I be right in assuming alternative sites would delay my bolus timings? If so typically by how long?

I inject my Tresiba into the top of my thighs; I was told those sites were slower in getting the basal into my blood stream, but since that delay is regular is doesn't really matter and my theory was that it reduced the general 'wear and tear' on my abdomen sites. I have applied a modest basal increase, but because its Tresiba I'm not expecting a quick response and assume I'll need to increase my bolus corrections for the time being.

I've no idea how long this surgery will take to recover from, but am assuming it could be a few weeks before things settle down. Right now I'm pretty sore and very immobile, so taking one day at a time!

Ideas please?

 

[Pumper_Sue]

Hope your recovery goes well for you.
There's no reason not to inject in your upper arms or your thighs. I never had any issues doing this for over 40 years. If you know absorption is a little slower in your thighs would it work to bolus sooner than you are now for meals?
Stress (surgery) will make your numbers higher so yes you can increase your basal as well as your bolus.

 

[helli]

This site looks helpful explaining injection site options and absorption rates.

Best insulin injection sites: Absorption time and rotation

Some common injection sites for insulin include the abs, arms, thighs, and buttocks. Read on to learn more about the benefits of common insulin injection locations to help manage diabetes.

www.medicalnewstoday.com

The rate of absorption is personal so i don’t think there is a fixed time difference.

 

[Proud to be erratic]

Hope your recovery goes well for you.
There's no reason not to inject in your upper arms or your thighs. I never had any issues doing this for over 40 years. If you know absorption is a little slower in your thighs would it work to bolus sooner than you are now for meals?
Stress (surgery) will make your numbers higher so yes you can increase your basal as well as your bolus.

Thank you. Yes pre-bolus timing is all important since I'm currently in the 13-14 zone and know that responses will be more protacted. Fortunately, I'm going nowhere today (!!!) and my sore throat is suppressing my appetite so I can do this in a leisurely manner. My main carb intake so far is water and paracetamol, so not too difficult to carb count.

 

[Proud to be erratic]

This site looks helpful explaining injection site options and absorption rates.

Best insulin injection sites: Absorption time and rotation

Some common injection sites for insulin include the abs, arms, thighs, and buttocks. Read on to learn more about the benefits of common insulin injection locations to help manage diabetes.

www.medicalnewstoday.com

The rate of absorption is personal so i don’t think there is a fixed time difference.

Thank you very much. Still got a full time job - sleeping!

 

[SB2015]

Using your thighs may impact on your absorption but it is all individual, so just make adjustments to pre bolus timings.

I found that once my levels were higher than normal I needed to add a bit to both my bolus and my corrections. I changed the amount of increase depending on how high my levels were. Certainly after an op I found that my levels were higher than I was used to. It is good that you have the sensor to monitor changes and can use this to help make necessary adjustments to your usual regime.

I hope that things settle soon.

 

[helli]

Using your thighs may impact on your absorption but it is all individual, so just make adjustments to pre bolus timings.

Despite the specialists’ wisdom, I find my thighs usually work faster.
I think it has something to do with me rarely staying still for long so my legs are moving more than my abdomen.

 

[DaveB]

My DN suggested the upper arm which I've now been doing for a few months; same place that covid/flu injections are made.

 

[Proud to be erratic]

Using your thighs may impact on your absorption but it is all individual, so just make adjustments to pre bolus timings.

I found that once my levels were higher than normal I needed to add a bit to both my bolus and my corrections. I changed the amount of increase depending on how high my levels were. Certainly after an op I found that my levels were higher than I was used to. It is good that you have the sensor to monitor changes and can use this to help make necessary adjustments to your usual regime.

I hope that things settle soon.

Thank you.

My DN suggested the upper arm which I've now been doing for a few months; same place that covid/flu injections are made.

Thank you. Do you try to create a pinch or fold of skin, which I generally do on my abdomen? That seems a challenge with 2 hands but only one reaching round to the other arm! I've now jabbed twice on my upper arm and had to trust I'm finding an appropriate spot.

 

[Kaylz]

My Tresiba goes in my cheeks (sorry for the TMI) and bolus I always do left thigh breakfast, right thigh dinner and abdomen for my tea

 

[Lucyr]

I inject in arms for bolus, and thighs or bum for basal. You don’t need to pinch anywhere if you’re on small eg 4mm needles, though I pinch on my thighs only as it’s more comfortable.