How to Inject Insulin

Preparing instruments. Before injecting insulin, you need to prepare the insulin tube, needle and sterile alcohol swab. Read product labels carefully to be sure to use the correct type of insulin as insulin comes in short-acting, medium-acting, and long-acting. Your doctor will explain which type is best for you. ^[2] There are many different devices used to inject insulin, including syringes of various sizes, insulin pens, syringes, and pressure injectors.

• The syringe is the most common insulin injection device. Needles are reasonably priced and easy to find.
• Syringes come in a variety of types in terms of insulin capacity and needle size. Most syringes are made from plastic (disposable) and have a pre-attached needle at the tip. ^[3]
• General rule: Use a 1 ml syringe if the injection is 50-100 units of insulin; syringe of 0.5 ml if the injection dose is 30-50 units of insulin; 0.3 ml syringe if the injection dose is less than 30 units of insulin. ^[4]
• Previous needles were typically about 12.7 mm long, but shorter needles (4-8 mm) are equally effective and cause less discomfort.

Take the insulin out of the refrigerator. Insulin is usually stored in the refrigerator because cold temperatures prevent insulin from going bad; Basically, cold helps to preserve insulin longer. However, you should only inject insulin when the insulin is at room temperature. ^[5] Therefore, you need to take the insulin tube out of the refrigerator about 30 minutes before injecting in order for the insulin to warm up. Do not microwave the insulin tube or heat it to warm quickly, as this will destroy the insulin.

• Injecting cold insulin into the body often causes more discomfort and insulin also loses its effectiveness and efficiency. Therefore, you should inject insulin at room temperature for best results.
• Once opened and used, insulin tubes can be stored at room temperature for up to one month. The product may then expire or decrease in effectiveness.

Withdraw insulin into the syringe. Before you draw insulin into the syringe, you need to check to make sure you are using the correct type of insulin and that the insulin has not expired. Liquid insulin should not clot. ^[6] Wash your hands before opening the plastic cap of the insulin tube, then wipe the mouth of the tube with alcohol swab to sterilize it. Next, open the cap of the syringe, pull the syringe to the line corresponding to the amount of insulin you want to use, and then insert the needle into the rubber end of the insulin tube, while pushing the plunger down. Insert the needle into the insulin tube and turn the tube upside down, then pull the plunger up to draw just the right amount of insulin into the syringe.

• Short-acting insulin is transparent in color with no granules inside. Do not use if insulin is clotted or grainy in the tube.
• Medium-acting insulin is slightly cloudy in color and must be rolled between hands to blend well. Do not shake the insulin tube as doing so will cause the insulin to clump.
• Check to make sure the syringe is free of air bubbles. If so, pat the balloon to rise and inflate the balloon back into the insulin tube.
• Once you are sure there are no more air bubbles, carefully place down the insulin syringe and start looking for the injection site.

Draw two types of insulin into the syringe. Some types of insulin can be mixed together, but not all, so you should only mix insulin when directed and directed by your doctor. Your doctor will instruct you how much of each type of insulin to take. Add the insulin of both types together to get the total amount to be drawn into the syringe and proceed as directed above. Your doctor can also instruct you on which type of insulin to draw first, so you need to do it in the correct order. ^[7] Usually, short-acting insulin is withdrawn into the syringe before intermediate-acting insulin, and intermediate-acting insulin is withdrawn before long-acting insulin.

• Since short-acting insulin is transparent and long-acting insulin is slightly cloudy, you can follow the phrase “clear first, cloudy later” to remember the order in which to withdraw your insulin.
• Insulin is combined to provide both immediate and long-lasting effects in controlling blood glucose levels.
• Using a syringe makes it easy to combine different types of insulin, while other injection methods (like using an insulin pen) can’t.
• Not all diabetics need combination insulin to treat the disease effectively. Some patients may find this too complicated and time consuming. Normally, this would be an evolutionary process; Because diabetes worsens over time, more insulin is needed to effectively treat the patient.
• Your doctor who prescribes insulin needs to teach you how to inject insulin with a syringe so that you can practice under supervision before injecting yourself with insulin.

Select the insulin injection site. Insulin needs to be injected into the fatty tissue just under the skin, called subcutaneous fat. ^[8] Therefore, most insulin injection sites have a sufficient layer of subcutaneous fat such as the abdomen, thighs, buttocks or under the biceps. People who inject insulin every day need to change the injection site to avoid injury. You can change injection sites within one body part (injections need to be at least 2.5cm apart) or inject in another part.

• If insulin is injected deeper into muscle tissue, the insulin will be absorbed too quickly and can lead to dangerously low blood sugar (hypoglycemia).
• Injecting too much insulin into one site can cause lipid dystrophy, leading to the breakdown or accumulation of subcutaneous fat. You need to be aware of this as it can affect insulin absorption and if it does, insulin will not work when injected into the site of lipodystrophy. Therefore, changing the insulin injection site is very important.
• Inject insulin at least 2.5 cm from the scar and at least 5 cm from the navel. Do not inject insulin into bruising, swelling, or pain. ^[9]

Inject insulin. You can start injecting insulin once you’ve selected a site. The injection site must be clean and dry and can be washed with soap and water (do not use alcohol). Pinch the skin and fat and pull the skin away from the underlying muscle, then insert the needle at a 90° angle (perpendicular or straight up/straight down) if the tissue is thick enough. ^[10] For small amounts of fatty tissue (usually in type 1 diabetics), the needle should be inserted at a 45° angle for greater comfort. Then release the skin and inject the insulin slowly and steadily by pushing the plunger all the way to the end of the syringe.

• After the injection is complete, put the needle/syringe in a special container and keep it out of the reach of small children. Do not reuse needles/syringes. ^[11]
• Create a graph to track insulin injections. Your doctor can give you an illustrated chart to follow.

Leave the needle at the injection site for about 5 seconds. After injecting insulin into the selected site, it is best to leave the needle/syringe in place for at least 5 seconds to allow all the insulin to be absorbed into the tissue and prevent the insulin from seeping back out. ^[12] When injecting, it is advisable to limit body movement at the injection site to avoid discomfort. If looking at the needle makes you feel nauseous or weak, look away for 5 seconds before proceeding to remove the needle.

• If some insulin oozes at the injection site, you should press the skin with a clean tissue for 5-10 seconds to absorb and stop the insulin from flowing.
• Always remember to withdraw the needle at the same angle as when injecting (90° or 45°) to avoid tissue damage.