INJECTIONS
Good to Know
Information from the American Diabetes Association for people with diabetes
Injecting Insulin
Taking shots safely, correctly, and with little or no pain
Why injections?
Insulin is a lifesaving medicine for people with diabetes. But
there is no such thing as an insulin pill—it can only be taken
as a shot. However, today’s syringes and insulin pens are
much easier to use and much less painful than those in the
past. Many people say that they feel almost no pain at all
when they take an insulin shot.
How is insulin taken?
There are two ways to give yourself insulin: from vials or with
pens. If you are using a vial, you will also need syringes. If you
are using a pen, you will also need pen needles. Both the
syringes and the pen needles can be thrown away after you
use them. It is common to take more than one type of insulin.
Mealtime insulin is taken before meals to help manage food-
related rises in blood glucose (sugar). Long-acting insulin
helps to manage blood glucose throughout the day and
needs to be taken at the same time every day. Your health
care provider will tell you when to take your insulin and how
much to take.
How to inject
Your diabetes educator or other health care provider will have
taught you how to take your shots. Here’s a review:
˚ Choose your site. Insulin can be injected into the upper
arms or upper thighs, the abdomen either above or below
your waist, or the buttocks. Avoid scars, moles, and the area
around the belly button. Use the same area, but change the
spot where you give your shot each time to protect your skin
over time and ensure that the insulin is absorbed.
˚ Prepare the insulin. Some insulins need to be mixed be-
fore you give a shot. Your provider will tell you if you are using
this kind.
˚ If you use a syringe: Fill the syringe. First, draw air into
the syringe equal to the amount of your insulin dose. Push
that air into the vial. Then draw up the insulin into the syringe.
Check for air bubbles. Tapping the syringe should break up
the bubbles so you will get your full dose.
˚ If you use an insulin pen: Dial up your dose. Screw or
snap the needle onto the end of the pen. Then turn the dial
to the number of your dose. Before drawing up your dose you
need to push out a unit or two to make sure that the pen is
working. This is called an “air shot.”
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˚ Insulin shots should go into a fatty layer of your skin
(called “subcutaneous” or “SC” tissue). Put the needle
straight in at a 90-degree angle. You do not have to pinch
up the skin unless you are using a longer needle (6.8 to 12.7
mm). Small children or very thin adults may need to inject at a
45-degree angle.
˚ Wait 5 seconds before pulling out the needle. Counting to
10 is a good way to be sure that all of the insulin has gone in.
˚ Dispose of the syringe or pen needle (see below). Using
needles more than once is not recommended because the
needle gets dull with each use and will be more painful.
TREATING HYPOGLYCEMIA (LOW BLOOD GLUCOSE)
Insulin can make you more likely to have low blood glucose,
which can be dangerous if untreated. If your blood glucose
goes low (usually under 70 mg/dl), a good rule of thumb is
to take 15 grams of fast-acting carbohydrate, wait 15 min-
utes, check your glucose again, and repeat if necessary. You
can buy glucose tabs or gels for this purpose, but there are
also about 15 grams of fast-acting carbohydrate in:
˚ 4 ounces of juice or soda (regular, not diet)
˚ 8 ounces of skim milk
˚ 5–6 Life Savers candies
Storage and disposal
Store vials or pens in the refrigerator until they have been
opened. If the insulin freezes, you will have to throw it
away. Once you start using a vial or pen, it can be kept at
room temperature (less than 86 degrees) and out of direct
sunlight. Insulin is less painful if you take it at room tempera-
ture. Depending on the type of insulin, it may be good for
14 to 40 days after opening. Check the package insert or
ask your pharmacist or provider. Do not use clear insulin that
has become cloudy or any insulin that has become clumpy.
Check with your town or county about how to safely dispose
of your used needles. Many places allow you to put used
needles in a puncture-proof container like an empty laundry
detergent bottle. Tape the top of the container closed and
put it in the trash—not the recycle bin.
Special needs
If you have trouble seeing the marks on a syringe or drawing
insulin into a syringe, ask your diabetes educator or pharma-
cist about devices that can make taking insulin easier.