Insulin Injection in the Buttocks: Safe and Effective Site
Yes, insulin can be safely injected into the buttocks, which is one of the recommended injection sites due to its abundance of subcutaneous tissue that makes intramuscular injections less likely.1
Recommended Injection Sites
- The buttocks (posterior lateral aspect of both upper buttocks and flanks) are among the four recommended sites for insulin injection, along with the abdomen, thighs, and upper arms 1
- The buttocks have abundant subcutaneous tissue, making them an excellent injection site that rarely requires a skinfold technique 1
- Absorption rates differ between sites: abdomen has the fastest absorption, followed by arms, thighs, and buttocks 1
Advantages of Buttock Injections
- Lifting a skinfold is rarely needed in the buttocks due to the abundance of subcutaneous tissue, reducing the risk of intramuscular injections 1
- The buttocks have a lower risk of intramuscular injection compared to thinner areas like the thigh 2
- Buttock injections may be particularly beneficial for patients with low BMI or lean body mass who are at higher risk for intramuscular injections in other sites 1
Proper Injection Technique for Buttocks
- Use a 4-mm pen needle inserted at a 90-degree angle for most adults regardless of BMI 1
- If using a needle longer than 4-mm or a syringe, consider using a skinfold technique, though this is rarely needed in the buttocks 1
- Ensure the injection site is clean and intact before injection 1
- After inserting the needle, press the injection button completely and wait approximately 10 seconds before removing the needle from the skin 1
Site Rotation Considerations
- Systematically rotate injection sites to prevent lipohypertrophy (thickened tissue) that can affect insulin absorption 1, 3
- When using the buttocks, inject into the posterior lateral aspect of both upper buttocks and flanks 1
- Rotate within one area (e.g., systematically within the buttocks) rather than rotating to a different area with each injection to decrease variability in absorption 1
Important Precautions
- Avoid injecting into areas with lipohypertrophy, scars, stretch marks, or tattoos 1
- Allow insulin to reach room temperature before injection (30-60 minutes out of refrigerator) to minimize pain 1, 3
- Avoid injecting through clothing as this prevents proper site inspection 1
- Be aware that absorption rates from the buttocks are slower than from the abdomen, which may affect the timing of insulin action 1, 4
Special Considerations
- For patients who need assistance with injections, the buttocks may be a practical site when self-injection is difficult 1
- The upper arm is the least preferred site for self-injection as it may be difficult to ensure the optimal angle or perform a skin lift independently 1
- For patients concerned about pain, the buttocks may be a less sensitive injection site 5