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Gary Scheiner says

Seems like the whole world is against lean people these days!  
 
Being lean will create some challenges when wearing a pump, but it's nothing that can't be overcome with proper infusion set selection and site rotation.  Angled sets (opposed to straight-in/perpendicular sets) are usually best for lean individuals, as the angle can be adjusted based on the thickness of the fat pad.  The buttocks is an excellent infusion site for lean kids (not to mention lean adults) -- the upper/outer portion of each "cheek".  Rotating the sites in an organized way, so that a multitude of spots are used and no area is overused, will help to prevent the buildup of scar tissue, lipodystrophy and irritation. 

Laura Plunkett says

My son started the pump when he was ten years old. He had very little body
fat, and he had to pinch up skin from his belly to insert the site for the
pump. Our endocrinology nurse helped Dan with his technique, and he didn't
have any issues with it. One thing to keep in mind is that there are several
different infusion sets, and your endocrinologist can help determine which
would be best

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