Infusion Site “Handles,” aka Diabetes Belly Love

Did you know that you get little rolls of “insulin fat” on your frequent insulin injection/infusion site spots? Yuck! Maybe I’m just naive, but I thought those little bulges developing on my otherwise-gratifyingly-flat stomach were just advancing age. Or too much cheese.

But my endo took one look at my tummy a few weeks ago, and said, “Those sites are overused! Can’t you see the damage? It’s plain as day.” She took out a ballpoint pen and actually drew circles just like these:


Furthermore, when I had some catch-up OmniPod training with the Insulet rep a few days later, she just shook her head. “Clear to see, but it’s not that bad. I’ve seen some patients who have little baseballs of fat in the spots they keep using.” Ooh, too much information.

She says my spots are still “fresh” enough that I might be able to reduce the puffiness by applying warm compresses regularly in the evenings. If I ever got around to sitting down quietly for more than a few minutes at a time, that is. Usually by the time all the kids are quiet upstairs, I flop on the couch for a very short TV respite before going to bed, and there ain’t no way I’m getting back up to prepare a special “warm compress” for my belly. Not unless it’s life-threatening, that is.

Anyone else experiencing these “diabetes love bulges”? If so, what have you done about it? (Other than the old cover-up with clever fashion selections…)


38 Responses

  1. Kelly K
    Kelly K April 9, 2008 at 7:00 am | | Reply

    I’ve actually heard people refer to it as “diabetic stomach,”and I’ve seen it occur on the legs and arms of diabetics as well, especially back in the days when those were
    the most common injection sites.
    I really try and rotate my sites, but between dead spots and areas that have “access issues,”I just kinda role with it & rotate daily.
    I am going to try the hot compresses though, thanks!
    Gilda Radnor was right, “It’s always Something! Especially when it comes to Diabetes ;)

  2. Molly
    Molly April 9, 2008 at 7:09 am | | Reply

    Are you freaking kidding me?! I can just see our future walk-a-thons.

  3. Allison Blass
    Allison Blass April 9, 2008 at 7:37 am | | Reply

    I have enough “normal-people” fat on my stomach for this not to be an issue! But if I ever lose that extra, uh, few pounds maybe I’ll see a difference.

  4. Ed
    Ed April 9, 2008 at 7:50 am | | Reply

    That’s why I use my ass – enough space on there to rotate spots all the time!

  5. Stanislav
    Stanislav April 9, 2008 at 7:50 am | | Reply

    I inject only on the sides of my tummy, along the hips. That’s the place where it hurts the least. No wonder it’s the only place where I have significant fat padding and hurts less…
    Possibly the best piece of d-info this year!

  6. Erin
    Erin April 9, 2008 at 7:57 am | | Reply

    I had heard of this, but I didn’t know what it looked like. I also believe I have enough regular fat on my belly that this isn’t the same kind of problem for me, but maybe not. They’ve never inspected me at the endocrinologist’s, though…

  7. Bernard Farrell
    Bernard Farrell April 9, 2008 at 8:07 am | | Reply

    I had this pretty badly and little further out from my belly button than your areas.

    After speaking with Gary Scheiner about this, I started to use locations around the existing areas. And this time I was careful to leave my old infusion set in place until I’d put in the new one. That way I could place the new set about 2 inches from the old on the SAME SIDE.

    So now I work all through one side of my abdomen and then switch to the other. I also try and do a few on my back.

    I followed this technique and those puppies were gone within about 4 months.

  8. Jonathan
    Jonathan April 9, 2008 at 8:10 am | | Reply

    Thank you so much for bring this up. For years I have told family members that the small roll around my belly that never goes away was because of all of the injections there and using it as an infusion site, and nobody believed me, saying I just needed to eat better and exercise more. What to do with them? Keep them with pride, as long as they don’t get tood bad. They are a sign of a long life with diabetes.

  9. Nicolep
    Nicolep April 9, 2008 at 8:38 am | | Reply

    Back in the day we called that hypertrophy. I have it on my belly from years of refusing to inject anywhere else… Ugh. Damn D.

  10. CALpumper
    CALpumper April 9, 2008 at 8:45 am | | Reply

    I call them “insulin sacks”. Old ones of course. Like scar tissue.

    I have it too. After all these years I finally don’t care. Would be nice if they went away. I do rotate my sites from each side of my stomach to each side of my back side. I tried my thigh recently too.

    It never ends I tell ya but whatever. Could be worse!

  11. Sara
    Sara April 9, 2008 at 9:02 am | | Reply

    It is a vicious cycle for me. My hips have the most padding for infusion sites, so that’s what I use. By using it, I am not helping reduce the ‘padding’ – making it a great place to use all the more.

  12. Scott
    Scott April 9, 2008 at 9:11 am | | Reply


    When I was still pumping, my CDE actually accused me of reusing the same sites too much which wasn’t the case at all; it was lipdystrophy which in spite of regular rotation happens because lets face it: insulin was never intended to be subcutaneously injected. I finally gave up, but it can wreak havoc on insulin absorption, so pay close attention to it!


  13. Sara from Team Sweetpea
    Sara from Team Sweetpea April 9, 2008 at 12:12 pm | | Reply

    Yep, I’ve got ‘em. The first 5 or so years I had my pump I used my lower abdomen only. Now I mostly use my thighs, and I’m hoping they don’t get all huge…

  14. gretchen
    gretchen April 9, 2008 at 12:55 pm | | Reply

    I wonder if anyone has ever tried body sculpting by injecting where you wanted more padding . . .

  15. Romeo from the great white north
    Romeo from the great white north April 9, 2008 at 1:41 pm | | Reply

    I have been pumping for around 5 years and have had theses off and on. I started using the CLEO infusion sets and have found less of a problem as the insert seems to be a cleaner more crisp operation. I see that the legs may be a problem for you with the Omnipod.

  16. Sarah
    Sarah April 9, 2008 at 2:27 pm | | Reply

    I use the 45 degree sets, and I also leave the old one in until I insert the new site (to allow proper spacing). I also almost only use my butt too. I’ve always been thin with a nice, firm, round apple booty, and I’ve never had a problem. :) Works for me!

    I also angle my sets in deeper, closer to muscle (but not in it of course).

    I did use my abdomen for a few weeks…and I did get some fatty pockets. It looked horrible, like my abs had bloated out. Thankfully, these went away.

    I agree with Scott…insulin is NOT meant to be injected (or inhaled…check out the latest Exhubra/Cancer link). It’s always “blame the diabetic” for everything that goes wrong…

    We should be blaming researchers for the millions wasted and still no cure…and primative technology for this day and age.

  17. J Di Napoli
    J Di Napoli April 9, 2008 at 5:19 pm | | Reply

    I just found out about this myself from the Nurse Practitioner in the CGMS clinical trial I am in. After 35 years of Type I you would think that someone would have mentioned it before. I switched my sites to my back side/hip. The nurse said that she thought there was improvement even after using my stomach for so many years. I just thought it was me that I could not get my stomach totally flat – even with exercise!!

  18. d2
    d2 April 9, 2008 at 5:30 pm | | Reply

    Welcome to rotation.

    I have graduated from 8-12 shots every day to infusion site locations. These are my suggestions. I start by starting at the top just below the rib cage and go straight down. Next, move over 2 inches from the center line and move down. Next start by writing www’s across the belt line to the back. If I can reach it, it is a location. After approximetely 10-12 locations on one side, I next begin the process on the left side of the center line and process from the top to the bottom. I have been successful in avoiding what you have described. Hope this helps and have a great day.


  19. d2
    d2 April 9, 2008 at 5:50 pm | | Reply

    Rotation, rotation, and rotation. For shots, finger blood glucose samples and pump infusion.

    This is a follow-up to my prior comment and this one is focused on blood glucose sample using lancets. It is the same challenge. I start with my right hand. Pointer finger is morning tests, middle finger is luch time, dinner is the ring finger and evening and bed time is the small finger. Right hand one week, left hand the second week. I start at the thumb side and move around the outside of the finger and when necessary, center back from the middle finger side, closer to the center and back around. This rotation is done on each finger throughout the day. The big issue is the black spots. BD has lancets which are 33′s. The smallest and the finest. Warm fingers via washing with warm soap and water is a great way to go. I have observed that a cold hand and cold weather with a need to test and a challenge to warm my fingers is the time that I lance too deep and get the black spots in your earlier picture of your finger picture. Hope this helps and have a great day.


  20. Linda B.
    Linda B. April 9, 2008 at 9:33 pm | | Reply

    For several years after I was diagnosed as a kid I would only inject in the sides of my thighs. No where else ever. I have now been sporting diabetic thighs for over thirty years now. I also have the buggers on my abdomen too. I switch and rotate and do all of that but mine stay with me all the time. I have decided to love tankinis and wear shorts with a little more lenght in them, that really has more to do with my cottage cheese butt than any thing. I just wish those little insulin flabs matched on either side of my tummy, might as well have a matched set if I am going to have to live with them!!!!!

  21. faye
    faye April 9, 2008 at 10:32 pm | | Reply

    my boyfriend has affectionately given that roll on my belly a name: “Bump.” he says he doesn’t mind, because it’s a sign of the 15 years i’ve been type 1…but i sure as heck mind when it sticks out!

  22. Gene
    Gene April 10, 2008 at 3:37 am | | Reply

    Puffiness or not, it’s a stomach to be proud of, Amy.

  23. Kendra
    Kendra April 10, 2008 at 6:58 am | | Reply

    I had a flat stomach before diabetes – about a year into 8+ shots a day I had two distinct humps of fat/scar tissue on either side of my belly button. They’ve actually receded a lot since I’ve been on the pump and I haven’t noticed any significant “build up” anywhere else. I try to rotate as much as I can. I don’t think the damage has to be permanent, necessarily :)

  24. Lyrehca
    Lyrehca April 10, 2008 at 11:42 am | | Reply

    Am I the only one who doesn’t see excess fat on the picture above? My stomach hasn’t been flat since childhood, despite taking shots for many years (long before I actually gave shots in my stomach). To me, I see someone who can wear a cropped top, above. If those are the fat pockets you’re worried about, in my opinion, there’s nothing to worry about.

  25. June S.
    June S. April 11, 2008 at 4:08 am | | Reply

    You don’t even have a problem, Amy! I’ve had Type I diabetes for almost 35 years. In those days we took primitive insulins (made of pork). My left thigh still appears to have had a bite taken out of it by a shark. It is permanently dented. I have dents in my side, and dents in the skin on my back. When I insert my Paradigm 522 insertion sets into my buttocks, the insulin absorption is so poor that I need to take about 30% more insulin! Believe you me, Amy, you haven’t even got a problem. Also, you were diagnosed so late in life that any potential skin bulges won’t become apparent until you’re in your 70′s!!!

  26. gregPfaff
    gregPfaff April 13, 2008 at 9:47 am | | Reply

    If I am looking at the same things I had. My doctor told me not to worry also. I switched to Apidra over a year ago and those little knots are gone. I understand there is research ongoing to see if the fact that apidra does not have zinc in it that this might be the reason for not getting those “knots”
    I’m sure you can find out more and let us know
    Thanks Greg

  27. bryan wasserman
    bryan wasserman April 13, 2008 at 9:53 pm | | Reply

    Fortunately I’ve still got the 6-pack abs that distract people’s attn from my 2 blobs of lipotrophy. At least that’s what I tell myself! I didn’t notice them since they came on slowly, but a few diabetes professionals to see me about 18 mos ago shook their heads and encouraged me to quit leaving sets in for 5+ days. I followed their advice. And then last year shifted away completely from the 4″ L&R of my bellybutton (no easy feat for me). And yet they’re still there! Maybe it began with shots I was taking pre-pump, which means they took at least 10 yrs to develop–it’s probably not long enough yet for me to worry they won’t disappear. (25 yrs t1 and just under 9 yrs pumping)

    1. chris collini
      chris collini November 24, 2011 at 10:48 am | | Reply

      I will start using an isulin pump next week, and one of my concern is taht I simply don’t have enough fat to use. I’m more muscular and have very little fat on my infusion happy sites. With muscles in the stomach area and little hips and buns ‘m worried. My legs also seem out as I;m male and have mostly thin legs too. Any ideas? I can barely pinch an inch on my stomach.

  28. Heather
    Heather April 16, 2008 at 12:49 pm | | Reply

    I’ve been trying to figure out why one side of my stomach is “bumpier” than the other! I definitely inject on the left more than the right.
    Like someone else said, the more cushioning a spot has, the easier it is to inject there… so it becomes a cycle.

    I can’t believe I’ve never heard mention of this before. (T1, 26 yrs.)

  29. Denise
    Denise April 24, 2008 at 2:17 pm | | Reply

    Hey, I have the same problem as June S. I started 30 years ago on pork insulin and my stomach all the way up to my ribs in dented. It looks like a I have a flesh eating virus. My doctor calls it Lipodystrophy. It is getting worse, you can tell I have a dent through my clothes. My Dr isn’t familiar with this at all, he’s only been practicing for 19 years. Does anyone have any ideas?

  30. MelissaBL
    MelissaBL July 17, 2008 at 7:25 am | | Reply

    I’ve pumped in the belly for 8 years and no one mentioned this to me until last month at the CDE. She asked me about my pooch that I had never attributed to anything but me being a little out of shape. Her advice was that I should avoid that area for about 6 months and use my butt, thighs, and hips instead. So far, so good. It’s been a month and a half and I think I already see improvement.

    As a kid, I had the “baseball” issue in my arms because I gave myself my injections and could only reach maybe a 2×2 inch space at the angle I used. When I moved to my abdomen, the arms got better. I swear – they want us to be healthy and lean so that our bodies are more efficient and yet, we need fat in as many places we can get it just to have rotation flexibility. It’s more than a conundrum – it sucks.

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  32. Willow
    Willow January 9, 2010 at 12:08 pm | | Reply

    To bad we can’t inject into our boobs! ;o)

  33. ginny
    ginny February 2, 2010 at 3:56 pm | | Reply

    I totally have these in my love handle area! I thought for the longest time that I just needed to loose a little weight, and then last week I got a CGM. I realized I have a slow absorption rate realitively speaking, and started looking for answers for that. Those areas were always deemed as fine by my endo cause they weren’t hard scar tissue, but I knew something was up. The shape isn’t right, even for having a little extra weight, plus when I was a kid I got the same thing in my thighs from mult. injections. Glad to see my theory was right- though now not sure what to do about it since it is the only comforable area.

  34. Counsel
    Counsel April 6, 2010 at 11:04 am | | Reply

    Actually, medtronic users, some, do pump in the breast… Not sure about any issues (I’m male).

    However, I’m starting to rotate to see if I can eliminate the handles-I’ve had diabetes for 30.5 of my 41 years.

  35. Deb
    Deb January 20, 2014 at 2:52 pm | | Reply

    I realize this thread is pretty old by now, but just in the interest of fun, I use my breast tissue for infusion sites. I have good absorption (not as many post-baby street mark scar tissue problems) and don’t have to worry about pockets of fat, cuz, well, it’s supposed to be there!!!!

  36. Colleen
    Colleen April 6, 2014 at 4:01 pm | | Reply

    I have been Diabetic for 26 years. During my teen years and twenties I would shoot my insulin all the time in my lower abdomen. Now I have a pouch. I hate it. Now I fear it is too late. Any other suggestions other than hot compress? I do cardio 4 times a week and sit ups! Aahhh

  37. Abby
    Abby September 9, 2014 at 11:56 am | | Reply

    I have been a type 1 diabetic for 19 years. I’m 21 years old. Been on an animas insulin pump for 11 years. I was just told yesterday by my doctor that I use the same areas for my insets and need to rotate more. I used to get injections in my thighs and my juvenile endocrinologist would refer to it as saddle bags on my thighs…but it was the most comfortable to do. I now have the ring around the belly d/t the insets being in the same general area. I have not used the front of my stomach for 3 years. And it has not gone away. I wish someone told me 11 years ago when I was 10, that that is what would happen if I didnt rotate my sites. However on my sides is where its at now. I hope the warm compress works, very self conscious and will not wear a bathing suit. Never have. I am also on Apidra and still experience it. I used to be on humalog and apidra does the same thing. We’re all different when it comes to absorption of insulin…but glad to know I’m not the only one who has experienced this!

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