Lumps and bumps around insulin injection sites

Injection sites for diabetes management

Regular insulin therapy helps people with diabetes manage their blood sugar. But you may have noticed lumps or bumps on your skin around insulin injection sites. There’s no need to worry about this normal side effect of insulin therapy. Here are answers to some questions about these bumps and how you can avoid them.

 

What are the lumps and bumps at insulin injection sites?
 

When fat cells come in contact with insulin, they can increase in size. If this happens in the same spot over and over again, you can develop lipohypertrophy. This is the medical term for a lump under the skin from a buildup of fat at the infusion or insulin injection site. Scar tissue, or hardened areas, may also develop at these sites. Easy-to-reach infusion and insulin injection sites (both sides of the belly button and on the sides of the thighs) are more prone to getting these lumps and bumps. Anyone who takes insulin can develop lipohypertrophy, whether they use a syringe or an insulin pump.

 

What happens with these lumps and bumps?
 

Developing lipohypertrophy can affect how well you can control your blood sugar with insulin. Affected areas don’t absorb insulin as well. In fact, as it progresses, the more likely it is that glucose control will be affected. Sometimes these areas have damaged nerve endings, leading to a loss of feeling, so you will not feel the needle going in at all. This is a sign you should stay away from that spot. As long as you stop using the affected site, lipohypertrophy should go away on its own in a matter of weeks or months.

 

How can you prevent lipohypertrophy if you need to take insulin?
 

If you tend to use the same spots repeatedly, you may want to use one of these approaches:

  • Use a visual body map. Imagine a clock or the letters “M” or “W” on a body part like your abdomen. Trace your finger along this shape. The next time you poke your skin, try a different spot along this imaginary shape.
  • Create your own simple method. Try this: if you insert a glucose sensor on the right side of your body, then do your next injection or next couple of infusion sets there, too. The next time you change your sensor and move it to the left side, insert your next couple infusion sets on the same side.
  • Track sites with a calendar. On specific days of the week, you can do injections or infusion set insertions on the front side of your body while the other days could be reserved for the back. You can reserve certain times of the year for specific areas of your body, as well. You could try to wear infusion sets on the back of your arm when you’re more bundled up during the winter or your buttocks more often during swimsuit season. This will allow longer periods of time for tissue on other sites to heal, too.
  • Talk to your doctor about new injection locations. There may be areas you haven’t thought of using to avoid lipohypertrophy. Just remember, any time you use a new area for injection or insertion sets, you may need to test your glucose more frequently since insulin will be absorbed differently. If you have been using your abdomen (where insulin is generally absorbed the fastest) and start using your buttocks (where insulin is absorbed more slowly), you may see your glucose values change more slowly.

Here's a guide of some potential areas to use during insulin therapy:

insulin injection sites   

Before you inject insulin or insert a new infusion set, take a moment to firmly stroke the areas in a sweeping motion to feel for any lumps. If you find areas with lumps and bumps, allow them to heal before using them again. Healing time will vary, but you may want to wait at least a few weeks. We hope these tips help you as you continue to use insulin. Thanks for reading!  

 

IMPORTANT SAFETY INFORMATION
  • Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems.
  • Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms.
Medtronic Diabetes Insulin Infusion Pumps
  • Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day.
  • Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.

[Originally published 2012-01-17. Updated 2023-06-19]

 

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Submitted by Sara (not verified) on

In reply to by Commenter (not verified)

This is great! I had been putting my infusion sites on my "love handles" for a while because that was the easist location for me, and for a while, the most predictable. Well, I think I overused those sites because I started to have absorption issues. Now that it is winter and my sleeves are longer, I am having some good luck using the back of my arms.

Submitted by Sonja (not verified) on

In reply to by Sara (not verified)

You sound exactly like my 9 year old daughter, Zoe Everytime we tried her tummy area, we hit a vein. She preferred her sides but now it's beginning to form lumps, so she finally allowed me to try the back of her arm!!

Submitted by Chris (not verified) on

In reply to by Sonja (not verified)

I really appreciate this article, some decisions are particularly hard to make, when, for example, I've used the same location for years, taken long breaks, come back, and I'm curious how one can contribute the the healing process, how to speed up, in a sustainable way, healing from Lipohypertrophy, and also, could you write an article, regarding how to avoid hitting blood vessels? Maybe I'm just being silly and it's simply a matter of choosing areas with more fat, but I just had the frustrating experience of having 3 failed sites in a row, all due to bleeding. Maybe it has to do with the Quick-serter and the length of the needle of the quick set? I have been using the same quick serter, all along for Paradigm quick sets, usually using 6 mm canulas, since i have very little fat and I am finding it hard to, in a predictable fashion, choose the spots that will most likely be good for insulin absortion, taking all factors into consideration? I know I need to experiment more, or else I'll go crazy thinking doing the same thing but slightly different will somehow give me considerably better results!

Submitted by Nicole (not verified) on

In reply to by Chris (not verified)

Thanks for reaching out, Chris. This sounds like a good conversation to have with our 24-Hour Technical Support team. They may have suggestions available, including a different infusion set type. You can reach our teammates at 800.646.4633, option 1.

Submitted by Mindy (not verified) on

In reply to by Sara (not verified)

Does the back of the arm hurt more? I’m thinking about switching to that area. I only weight 125lbs so some of the other areas besides the abdomen I can’t really do because it’s so so painful. Thank you

Submitted by Kim (not verified) on

In reply to by Mindy (not verified)

I always thought that using the back "fatty flaps" of my arms or "triceps" would be painful but I have no other choice since i have extreme bloat from Gastroparesis & can no longer use my stomach for some reason. But it does not hurt! I sometimes find that the infusion set will peel away onits own when being used on my arms, maybe from the way i sleep or running against clothes, but what helps is Tegaderm Transparent Dressing. I cut a hole in the center of the bandage, just enough so the set pokes out and it works like a charm, no more lifting. It's clear and waterproof too.

I never had this lifting issue before but it started happening recently. The tricep area does not hurt and is a nice relief from the other areas more frequented.

Submitted by Dr. David Gree… (not verified) on

In reply to by Mindy (not verified)

Mindy, You should consider changing arms.

Submitted by Luis Moreno (not verified) on

In reply to by Dr. David Gree… (not verified)

Yes thats true, What I usually do is change arm every 3-5 days, and in like a month of doing this, ill change to the tummy area to let my arms rest, it really does help me.

Submitted by Shana (not verified) on

In reply to by Sara (not verified)

What happens when you massage a insulin lump to break it up? I just tried using a massage gun on my lump on my butt and it got really red, itchy and looks like it might bruise and some stretch marks are showing up. Any explanations?

Submitted by Nicole (not verified) on

In reply to by Shana (not verified)

Shana, this is a good conversation to have with your healthcare team, as reactions to these types of treatments are specific to the individual.

Submitted by Robin (not verified) on

In reply to by Commenter (not verified)

I have been diabetic for 20+ years and was put on insulin pump therapy in October 2011. I have problems when a site works for the first day then it is as if I have no insulin working after that. I was told to only use my abdomen, so I can't change sites a lot, but, I am running out of sets from changing them so much to try to find a site that works. Any ideas?

Submitted by Rachel (not verified) on

In reply to by Robin (not verified)

Robin, I have had an insulin pump for almost ten years and would love to know the answer to that. I believe I must now have lipohypertrophy. Two days ago I was trying to insert CGM and took it out because of pain and all the sudden discovering a large lump which has turned into a huge bruise and smaller lump. I go through spots that work for a while and then it is like they become "immune" so to speak. I wish I had an answer because when this happens I tend to get pretty upset.

Submitted by Karrie Hawbaker (not verified) on

In reply to by Rachel (not verified)

@Rachel I’m sorry to hear that. I’ve sent your comment to someone from our HelpLine team who will reach out to you shortly to try to help.

Submitted by george grant (not verified) on

In reply to by Rachel (not verified)

I have had diabetes type 1 since I was six and am 48. Never have used an insulin pump before. I have used injections ever since i was diagnosed.

A few years ago I saw a picture of some boys who had pumps and only 10 years old!!

I have always wondered what is it like using one of those?

Submitted by Karrie Hawbaker (not verified) on

In reply to by george grant (not verified)

George, if you're interested in chatting with someone who uses an insulin pump, we have a great group of MiniMed Ambassadors who you can reach out to: www.minimedambassadors.com.

Submitted by Frankie (not verified) on

In reply to by Robin (not verified)

I was on an insulin pump for 3 years, unfortunately it didn't fit my lifestyle but I was never told to only insert canulas in the tummy area, I used to wear them in my legs & even round the soft tissue at the bottom of my back, I never had any problems with insulin being absorbed.

Robin I'm the same way as you. I done it in my legs and 4 days later like my muscles went on my legs.

I have been taking infections in my stomach since 2003. I have two lumps very big lumps on my stomach. They are embarrassing and I hate them. I've lost over 100 pounds and it's very noticeable. Do they ever go away? Afraid to take the shots anywhere else because of this. I'm a type 1 and will always have to take insulin. Please help. I'm not over weight. I use to be over 4 years ago.

Submitted by Teresa (not verified) on

In reply to by Commenter (not verified)

I can relate to Robin and Rachel. I've been on a CGM since June 2009. I'm having trouble finding insertion sites. My abdomen isn't good for the CGM b/c of lipothypertrophy (I've been on a pump for 25 years) and I'm currently using my hips and upper buttocks for the CGM, but I'm really struggling with finding new places. Any suggestions? Has anyone used the thigh area for the CGM?

Submitted by Karrie Hawbaker (not verified) on

In reply to by Teresa (not verified)

@Teresa the Medtronic sensor is actually only approved for use in the belly area. For infusion sites, there are more approved options (arm, thigh, top of buttocks). You can find more about site rotation and selecting sensor and infusion sites here: http://www.medtronicdiabetes.net/support/insertion-site-management. And if you’re having trouble with lipohypertrophy, I’d definitely check in with your healthcare team. They’ll likely have additional guidance for you.

Submitted by John Whote (not verified) on

In reply to by Karrie Hawbaker (not verified)

Lots of outdated correspondence here.
What’s up with that ???

Submitted by Nicole (not verified) on

In reply to by John Whote (not verified)

Thanks, John, for reaching out. As mentioned at the beginning of this blog, it’s one of our most popular blogs of all time and still relevant to the community so we decided to share so those who weren’t aware of it could still benefit. Hope you enjoyed it!

Submitted by Kate (not verified) on

In reply to by Commenter (not verified)

I do rotate my shots all the time, but it doesn't seem to matter where I give the shots it always leaves a bump and they hurt to touch..

Submitted by naomi.kingery@… on

In reply to by Kate (not verified)

Kate, I’m sorry to hear that. This sounds like a great question for your healthcare team as they can give you the best advice to meet your individual needs. If you have any questions related to a Medtronic device, let me know and I can connect you with someone to help.

Submitted by Brooke (not verified) on

In reply to by Kate (not verified)

Kate - Have you learned anything new about your reactions? Do you also react to insulin shots? I am curious because I am a type 1 that is suspected of having allergy to insulin. I am working with the Barbara Davis Center with this issue, and they would like more cases to study. Do you know anything else about your reactions?

Submitted by holley (not verified) on

In reply to by Kate (not verified)

I am going though the thing what shough I do

I also rotate sites but still get large bumps. I don't think I am absorbing the insulin because in the last few months my A1C has gone from 7.0 to 9.3!!!! What am I gonna do?????

Submitted by Karrie Hawbaker (not verified) on

In reply to by Tommie (not verified)

I'm sorry to hear this, Tommie. This is a good conversation to have with your healthcare team. They can make the best recommendation based on your individual needs.

Submitted by Nicole (not verified) on

In reply to by Commenter (not verified)

I've only been using insulin for about a year and I only have this on my legs. However the areas bruise, the lump appears and it itches like crazy. I wonder if it's the type of insulin might also help. Instead of using synthetic insulin or animal based....I actually asked if I was allergic to the brand I was using. I know the body produces it naturally but it's not pure there are additives added to the medication. Could it be a problem like that?

Submitted by naomi.kingery@… on

In reply to by Nicole (not verified)

Nicole, I’m sorry to hear you’re experiencing this. However, I’m not qualified to give medical advice. This is a question best asked to your healthcare team as they can answer questions specific to you and your needs. If you have any questions about a Medtronic device, let me know and I’d be happy to connect you with someone.

Submitted by Dale (not verified) on

In reply to by Commenter (not verified)

Been on insulin since December, 12. Have had no real problems. But, now I have a lunp in my abdomen that has enlarged since noticed about 4 days ago. About the size of a quarter, from, originally about 1 inch long and 1/3 inch wide. Also redness on surface at the site. No pain

Submitted by naomi.kingery@… on

In reply to by Dale (not verified)

Dale, I’m sorry to hear that. It sounds like you should consult your healthcare team as they can give you the best advice about this. If you have any questions related to a Medtronic device, let me know and I can connect you with someone.

Submitted by CHARI (not verified) on

In reply to by Commenter (not verified)

I have just started Insulin Injection . Is there an Ointment / Cream which can soften the Skin

Submitted by naomi.kingery@… on

In reply to by CHARI (not verified)

Hi Chari, I’m not qualified to give any kind of medical advice. I recommend that you ask your healthcare team as they can give you the best advice to meet your individual needs. If you have any questions related to your device, let me know and I can connect you with someone.

Submitted by Barry Eckstein (not verified) on

In reply to by Commenter (not verified)

Is there anything I can do to reduce or eliminate the bumps. I currently have bumps that are highly irritating.. I thought that if I use a heated damp towel on the area, that could do the trick. Any ideas?

Submitted by naomi.kingery@… on

In reply to by Barry Eckstein (not verified)

Hi Barry, I’m sorry to hear that. This sounds like a great question for your healthcare team as they can give you the best advice to meet your individual needs. If you have any questions related to a Medtronic device, let me know and I can connect you with someone.

Submitted by carol (not verified) on

In reply to by naomi.kingery@…

Naomi - it seems you have an auto response - "sorry, can't help you,speak to your healthcare team" - Some of this stuff is really basic - DO YOU KNOW OF ANYTHING THAT HELPS WITH THE LUMPS/PAIN/SWELLING? - Massage? some therapeutic oil? anything? - If not - why don't you just close this thread. What's the point of you repeating your non-answer over and over again. Why don't you let one of those "24-Hour HelpLine team members" get on and answer these concerns?

Submitted by naomi.kingery@… on

In reply to by carol (not verified)

I’m sorry you’re frustrated with the response we’ve given, Carol. We do recommend that our customers call the 24-Hour HelpLine if they experience any specific issues, as this is easier to handle over the phone instead of in writing. If you experience a lump, move your infusion set to new area and allow for the tissue to heal before using the site again. The amount of time it takes to heal the tissue just depends on your body. Because we do not know your specific medical situation, we recommend speaking with your healthcare professional, who would have a better understanding of your specific needs and can give you advice specific to meet those needs.

Submitted by victoria edwards (not verified) on

In reply to by carol (not verified)

hi hear hear right on i totally agree with you. Get off the site if you can't answer the simple question. I have been getting more and more lumps in my abdomen and they hurt. I wanted to know the same questions you asked. How do you get rid of them? I move it around all the time doesn't seem to work. I haven't tried anywhere else. I am afraid of going anywhere else it looks disgusting, a sac of fat hanging with bruises. Did anyone answer your questions if so please share help victoria.

Submitted by LOOP Blog Editorial on

In reply to by victoria edwards (not verified)

Hi Victoria, I’m sorry to hear you’re experiencing lumps and bumps (lipohypertrophy) from insulin therapy. Try to avoid using the areas of your body that have lipohypertrohy for your infusion set site, allowing the sites to heal before using them again. You may also find this article helpful: http://www.healthline.com/health/diabetes/lipohypertrophy#2. Since we’re not medical professionals, we recommend talking with your healthcare team about solutions that fit your specific needs to help you rid of lipohypertrophy.

Submitted by Lisa Pogue (not verified) on

In reply to by Commenter (not verified)

I started using the insulin pump about the middle of July, 2013. For several years I have had insulin site reactions when I gave myself shots. Now I am having them where I insert the insulin into my stomach. Works great the first 20 hours, but then does not seem to absorb as it should. I've talked to my health care staff and no one seems to know what to do. I'm getting very frustrated because I love the simplicity of the pump. Where can I find some assistance. Everyone seems to be scratching their heads.

Submitted by naomi.kingery@… on

In reply to by Lisa Pogue (not verified)

Lisa, I’m sorry to hear you’re having a hard time. I’ll have someone from my team reach out to you shortly to see if there is anything we can do to help.

Submitted by Debbie Stokes (not verified) on

In reply to by naomi.kingery@…

I have a lump that is hanging , what can I do to reduce the size. at first I thought it was a hernia but my NP told me it was from taking Insulin but she did not tell me any ways to reduce it.

Submitted by Karrie Hawbaker (not verified) on

In reply to by Debbie Stokes (not verified)

Debbie - this is a great conversation to have with your healthcare team as they can best address your individual needs.

Submitted by Lauren (not verified) on

In reply to by Lisa Pogue (not verified)

I've been using the insulin pump for a few years now and the best place for me to place mine was the back of my arms. Worked great until I noticed the lumps/bumps. Now they are very large and unattractive. I look as though I have giant sacs under my arm. Could anyone please inlighten me on how to fix this problem???

Submitted by Karrie Hawbaker (not verified) on

In reply to by Lauren (not verified)

Hi Lauren, if you'd like to chat with our 24 HelpLine about this, please give us a call at 800-646-4633, option 1.

Submitted by Angela De Decker (not verified) on

In reply to by Commenter (not verified)

Been a type 1 diabetic for 58 yrs, on insulin pump for 3 yrs. I occasionally get bleeding when I take out the infusion set, the a bruise appears, goes away in a couple of days. I use the top of my legs for infusion, and top of my stomach area, and away around the belly part. I have used a message machine to work on the stomach area, which seems to help. I really like being on the pump because I hated taking 6 needles a day prior to pump. Have been involved in a lot of studies in the London, ON area over the years, doing a water/intake study now. Was involved in a long term study for having diabetes for so long at St Joseph's Hospital, in London. For having diabetes so long I really don't have too many problems, either than CKA, on a strict low sodium, potassium carb diet. I have always had an endocronist looking after my diabetes, and now a Kidney Specialist. I was a child when I got diabetes, have 4 children, none are diabetic.

Can you tell me what causes the bleeding and the itching.

Submitted by Kelly (not verified) on

In reply to by Commenter (not verified)

What about when you do change your insertion sites on a steady rotation and you skin GOES INWARD or SINKS????? One of my butt cheeks is soooo "dented" inward it is amazingly bad. It is starting on my upper thighs as well. Thanks!

Submitted by Stephanie (not verified) on

In reply to by Kelly (not verified)

Hi Kelly,
I have the exact same problem! My upper legs/hips are indented, one side more than the other. I've had Type 1 for ten years, been on the pump for 6. I've always used this area, and just switch sides. I am going to try and move the sites to my lower stomach and see if the indentation goes away. Have you found out anything from your post that you could share. I can let you know how it goes with me. Thanks

Submitted by LOOP Blog Editorial on

In reply to by Stephanie (not verified)

Stephanie, it’s important to rotate your infusion set site each time you change your infusion set to help keep your tissue healthy and allow previous sites to heal before reusing them. I recommend talking with your healthcare team to find an insertion site that works best for you. You may find this article on site rotation helpful, too: http://www.loop-blog.com/4-tips-for-infusion-set-and-sensor-site-rotati…


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