Proper site rotation: pumps, injectables & CGMs

If you use a device or take medication that needs to poke your skin, it’s important to give your skin a chance to heal. That’s why it’s best to rotate where you use insulin pumps, injectable meds or continuous glucose monitors (CGMs). Using different places on your body every so often will lower your risk of skin problems. It can also increase your chances that the medication or device will work properly. The key is to find the best “rotation site” for your meds or device, and to know how often to choose a different site.

Common areas to use for rotating sites include the outer thighs, upper buttocks, hips, lower back, the back of arms and the abdomen (keeping a few inches away from the belly button).

How to find the right rotation site*:

• Choose areas that are easy for you to reach and see. Use many different spots in those areas.
• Make sure there is enough fat in the area. You should be able to “pinch an inch.”
• Avoid bony areas or areas with very little fat (like hip bones).
• Stay a few inches away from skin folds, scars and the belly button.
• If you use an insulin pump and CGM at the same time, have them placed at least three inches apart.
• For insulin pump sites and CGMs, avoid areas where they might be pressed on for long periods of time. Avoid putting those devices on areas of your body that you lay on, sit on or wear tight clothing around, or sites that might get bumped or pushed.

*Always review additional placement guidelines specific to your device for insulin pumps and CGMs.

How to rotate within a specific area:

• Stick to a plan so you can avoid overusing any given body area.
• Avoid just going from the right side of the body to the left.
• Stick with one side of your body for many injections or site changes. Only move a few inches each time you rotate.
• Map out the body part you are using into a “box pattern.” Pick rotation sites using that pattern. Finish one side of your body, and then move to the other side (see example below).
• Depending on the size of the body part, you could use a 2x2, 3x3 or 4x4 pattern, with the charts below. Larger bodies have more room, so a 4x4 pattern works great. Smaller bodies can still do well with a 2x2 pattern.

Example: 3x3 pattern on the abdomen

For more personalized help with finding the best rotation site for you, schedule a coaching session with one of our expert coaches.