How to Give an Insulin Injection

In This Article

Supplemental insulin—a man-made version of a hormone produced by the pancreas to control blood glucose—is vital for all people who have type 1 diabetes. It also may be a necessary part of treatment for those with type 2 diabetes when first-line measures—diet, exercise, and/or medication—aren't enough to control blood glucose.

Insulin cannot be taken as a pill or tablet because digestive enzymes would break it down before it could get into the bloodstream. Therefore, it must be injected—a prospect that may sound scary but in fact is routine for six million people in the United States, according to research published in 2016 in Diabetes Spectrum.

Whether you are new to self-injecting insulin with a syringe and needle, would like to fine-tune your technique or explore using an insulin pump or other alternative, or will be giving insulin shots to someone else regularly, there's much to know about how best to administer this medication safely and effectively.

What You Will Need

In order to inject insulin, you will need to always have on hand several items:

Insulin. This comes in small bottles or vials that hold enough insulin for multiple injections. Although most people take only one type of insulin at a time, for some it's necessary to mix two types.

Storing Insulin

All unused insulin, including prefilled cartridges and pens, should be stored in the refrigerator between 36°F and 46°F.; when this isn't possible, it should be kept as cool as possible (between 56°F and 80°F) and away from heat and light, according to Kaiser-Permanente. Once opened, a bottle of insulin can be kept at room temperature for a month.

Syringes. These are the clear tubes into which each dose of insulin is measured for injection. Syringes vary in size based on how much medication they can hold and are labeled either in milliliters (mL) or cubic centimeters (cc). Either way, the volume is the same: 1 cc of medication is equal to 1 mL of medication. Obviously, the size of the syringe you choose for injecting insulin will need to accommodate your prescribed dose.

Needles. Needles are labeled according to two measurements: gauge, which refers to the thinness of the needle, and length. Because insulin does not have to be injected deeply into the body, a short, thin needle should suffice: typically one-half to five-eighths of an inch long with a gauge of 25 to 30.

Alcohol wipes. Keep a generous supply of these pre-wrapped alcohol-saturated squares on hand: You'll need one to two per injection.

Sharps container. Syringes and needles must be disposed of safely. You can purchase a sharps container from a pharmacy or medical supply store, or use an empty laundry detergent container with a screw-top lid. When either is filled, they will need to be dropped off at a collections site. According to the U.S. Food and Drug Administration, this may be a doctor's office, hospital, pharmacy, health department, medical waste facility, or police or fire station, depending on local health department rules.

Using a Syringe and Needle

If you will be giving yourself an insulin shot, these are the steps to take:

Gather your supplies. As listed above, you'll need your prescribed insulin (which may be one bottle or two), a needle and syringe, alcohol wipes, and a sharps container.

Make sure you have the right insulin and that it has not expired: Any insulin left in an opened bottle should be discarded after 30 days.

Tip

To avoid using insulin that may have lost its potency, always write the date on the bottle when you first open it.

Look at the quality of the insulin. If you see any clumps, toss that bottle and get a fresh one. If you'll be using intermediate-acting insulin, it will look cloudy. This is normal. To mix it, roll it gently between your palms. Do not shake the bottle.

Wash your hands with soap and water and dry them thoroughly.

Swab the top of the insulin bottle with an alcohol wipe. If it's a new bottle, remove the protective cover. It should pop off with a little upward pressure.

Uncover the needle. Hold the syringe with one hand and with the other grasp the cap covering the needle and pull it straight off without touching the needle.

Fill the syringe. Pull back on the plunger of the syringe to fill it with the same amount of air as the dose of insulin you'll be injecting. Insert the needle into the rubber stopper of the insulin bottle and push the plunger to inject the air into the vial. Leaving the needle in the stopper, turn the bottle upside-down keeping the tip of the needle below the surface of the insulin. Pull back on the plunger again, just enough to fill the syringe to slightly more than the number of units needed.

Check for air bubbles. If any are trapped in the syringe, tap it gently with your fingernail to dislodge them. Push the air bubbles back into the bottle and pull back again to fill the syringe with the correct amount of insulin.

Choose and prepare the injection site. Insulin enters the bloodstream at different speeds—"more slowly from the upper arms and even more slowly from the thighs and buttocks," according to the American Diabetes Association (ADA). The ideal spot is the abdomen.

The Importance of Rotating the Injection Site

Although it's ideal to inject insulin in the same general area, it's also important to not inject it in exactly the same spot. Doing this could lead to the development of hard lumps or extra fatty deposits, which are both unsightly and likely to interfere with the effectiveness of the insulin.

Inject the insulin. With an alcohol wipe, clean the site by wiping the skin in a circular motion. Allow it to dry and then with the forefinger and thumb of one hand gently pinch up a bit of skin. With the other hand, hold the filled syringe at a 90-degree angle to the skin and push the needle into the skin all the way to the hub of the needle, then press the plunger all the way in to release the insulin. Leave it in place for five seconds. I

Remove the needle. Slowly withdraw it at the same angle at which it was inserted. You may see a drop or two of blood: Apply pressure with the alcohol wipe. The bleeding should stop within a few seconds.

Safely dispose of the used syringe. Being careful not to stick yourself, carefully place the cap back on the needle and put the syringe into the sharps container.

Syringe Safety

Never reuse a syringe. Once used it's no longer sterile and could be a source of infection. Cleaning a used needle with an alcohol wipe is not advisable: Doing so will strip it of the silicone coating that helps it to glide comfortably into the skin.

Never share syringes. Diseases such as AIDS and hepatitis are spread via blood; using a syringe someone else has used could put you at risk of infection.

If you are using two types of insulin, repeat these steps with the second bottle. Do not mix two types of insulin into one syringe unless otherwise instructed. Your doctor will tell you which type of insulin to inject first: Always stick to that order.

Troubleshooting

For most people, self-injecting insulin goes smoothly—at least once they get the hang of it. However, the process isn't without a few common glitches.

I keep forgetting to take my insulin. Missing just one dose per week can raise your A1C (a measure of average blood glucose levels over two or three months) by more than 5 percent, according to the American Association of Diabetes Educators. If you keep inadvertently skipping shots:

  • Set reminder alarms on your smartphone or watch.
  • Schedule injections for the same time you perform other regular tasks, such as brushing your teeth.
  • Store injection materials where you will see them.

The shots hurt. Most people find that self-injections of insulin are not painful—at least once they get the hang of doing them. If even after you've mastered the steps you still find it uncomfortable to inject insulin:

  • Bring refrigerated insulin to room temperature before using. When it goes into the skin cold, it can sting.
  • Relax the muscles in the area around the injection site.
  • Pinch the area where you'll be injecting so that the surface of the skin feels hard: The needle will glide in more easily and quickly.
  • Rub ice on the injection area to numb it.

Insulin sometimes leaks out of the injection site. This can happen even if you leave the needle in place for the recommended five to 10 seconds before withdrawing it. Leakage isn't a problem unless large drops appear, but it's best to prevent it if possible. To do this you can:

  • During the injection, release the pinch of skin before pressing down on the plunger to release the insulin.
  • Leave the needle in for longer than 10 seconds.
  • Insert the needle at a 45-degree angle.
  • After removing the needle, press gently on the injection site with a (clean) finger for five to eight seconds.

Alternative Injection Methods

There are a number of ways to take insulin besides using a needle and syringe. These include:

Insulin pens. There are two types, according to the ADA: Pens into which an insulin-filled cartridge is inserted and disposable pens that are prefilled and meant to be discarded after all the insulin has been used. For both types, the insulin dose is "dialed " on the pen and the insulin is injected through a needle. Cartridges and pre-filled insulin pens contain only one type of insulin; if you take two types of insulin, you will need to different pens.

Insulin pumps. Consisting of a reservoir to hold insulin and a pump, these devices connect to the body via tubing and use a cannula that holds a needle for delivering insulin into the body. All insulin pumps provide a slow, steady stream of fast- or short-acting basal insulin, with an option to deliver a larger dose of additional insulin (known as a bolus) at meals.

Insulin patch. There is only one such device on the market—the V-Go. Unlike traditional insulin pumps, this device is a credit-card size device that adheres to the skin. The patch holds a small reservoir and a pre-filled needle. Injection of insulin is triggered by pressing a button on the patch. It is designed to deliver both a continual flow of basal insulin and individual doses of bolus insulin.

A Word From Verywell

If you have diabetes and have learned you'll need to take insulin to help manage your disease, it's natural to feel a bit shell-shocked. The thought of sticking yourself with a needle multiple times a day is understandably daunting. But even though the idea may be new to you, it's actually an aspect of diabetes treatment that has been around for a very long time—long enough for biomedical engineers to refine the process so that it's as easy and painless as possible. And you won't be left to your own devices: Your doctor or a diabetes educator will help you learn the ropes of self-injection and also help you decide if a pen, pump, or patch is likely to work better for you than a traditional needle and syringe

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