5 Tips for Easier Insulin Injections
Whether you use syringes or insulin pens, injections may be a pain – literally. Here are techniques and tips to make injections as seamless as possible.
There are many ways to take insulin, including syringes, prefilled pens, or insulin pumps. How you take insulin is highly personal – different people have different dosage needs, timing, and preferences.
If you take insulin through injections, it’s important to choose and rotate injection sites properly and follow recommended steps to ensure safety. For the first time since 2016, experts from the Forum for Injection Technique and Therapy Expert Recommendations (FITTER) have updated recommendations on how to inject insulin correctly.
Here, we cover the key updates and offer helpful tips to make injections a breeze.
Choosing an injection site
When choosing where to inject insulin, always examine your skin carefully. Avoid injecting into damaged skin, such as tattoos, scars, irritation, wounds, or stretch marks. If you’re injecting insulin into a site on your abdomen, be sure to stay one inch away from the belly button on all sides.
It’s also important to avoid injecting into the same area repeatedly, said Shelly Milsted, a certified diabetes care and education specialist (CDCES) at the University of Maryland Baltimore Washington Medical Center. As a general rule, Milsted recommends injecting at least one finger’s distance away from the last injection site.
This distance helps prevent what’s called lipohypertrophy, which is when skin becomes lumpy due to fat deposits and can’t absorb insulin well due to injecting too often in the same spot. This can affect insulin absorption, making it less effective and potentially impacting diabetes management.
Steps for insulin injections
1. Gather supplies
Make sure you have everything you need before you start. This includes the insulin vial and syringe or injection pen, handwashing supplies, alcohol wipes, and a sharps container for safe disposal of syringes.
It’s a good idea to keep the insulin you’re currently using at room temperature. While it’s good practice to keep all unopened insulin vials in the fridge (FITTER recommends a refrigerator temperature between 36 and 46 degrees Fahrenheit), it’s worth noting that cold insulin taken directly from the fridge may sting or burn when injected, Milsted noted.
Milsted also said that the “out of sight, out of mind” mindset can play a role in missed insulin doses. “It’s visually helpful to have your insulin out at room temperature, where you’ll see it and know you need to take it,” she explained.
2. Choose the shortest needle length
Always use a short needle length and a thin width (researchers recommend 4 mm for pens and 6 mm for syringes, with a 32-gauge width) to minimize discomfort and ensure that insulin is absorbed consistently.
3. Prepare a syringe or injection pen
Always wash your hands or use hand sanitizer before injecting insulin to prevent infections at the injection site. Then disinfect the injection site using an alcohol swab or wipe.
If you’re using syringes, use a fresh needle for each injection since sharp needles reduce pain and trauma to the skin. Insulin injection pens are multi-use devices. Each pen provides a specific amount of insulin: for instance, the Tresiba and Novolog U100 pens contain 300 units of insulin.
Draw up the correct amount of insulin into the syringe or dial your insulin dose on the pen according to instructions from your healthcare provider or CDCES.
4. Inject just under the skin
Insulin should be injected into the fatty layer just below your skin – this is called a subcutaneous injection. If you inject too deeply, the insulin may be injected into your muscle and be absorbed too fast; this situation can cause low blood sugar (hypoglycemia). Plus, injecting into muscle is generally more painful.
Before you inject, relax the muscles in the area you’re injecting to make nerves less sensitive – it may help to take deep breaths or sit down. When you’re ready, insert the needle straight into your skin (at 90 degrees) with a quick, smooth motion. Avoid applying too much pressure, so you don’t force the needle into the muscle below the fatty layer.
If using a syringe and a 6 mm needle, pinching and lifting the area can help prevent injecting into the muscle. Pull the needle out of your skin and release the pinch after injecting. Older people, children, very thin people, and those who are pregnant should discuss proper technique with their health care provider or CDCES.
5. Dispose of needles safely
Do not reuse needles. Use a hard plastic container, sharps box, or medicine bottle to properly dispose of the used needle(s). Proper disposal of sharps may vary based on where you live – be sure to check your state’s guidelines.
Pen needles are “one and done” products that should be disposed of immediately after use.
“Avoid keeping used pen needles on, as the insulin may crystallize and bacteria could get inside the injection pen,” Milsted said.
Where to get additional help
A diabetes educator (such as a CDCES) can be a great resource for any questions or concerns you have about injections. A CDCES can help you overcome a fear of needles and master injection techniques – some may even help you practice on a mock injection pad.
Several companies also make special shields to hide the needle, which can be helpful if you have a fear of needles. However, Milsted noted that insurance doesn’t always cover these products and advised reaching out to your insurance plan ahead of time.
Depending on your insulin dose timing, Milsted said you might even be able to give yourself an injection at an appointment with a diabetes educator. That way, they can observe your injection technique and provide feedback in the moment.
Milsted advised against practicing injections at home, even if you have something you can use as a mock injection pad. Instead, she suggested scheduling a visit with a healthcare provider or diabetes educator.
If you’re having trouble keeping track of your insulin doses, consider trying a smart pen. These devices can calculate the appropriate insulin dose, track the time and amount of each dose, remind you when it’s time for your next dose, and tell you when your insulin has expired. There are also many apps available to track your insulin doses, such as Glooko and mySugar.
If insulin injections aren’t working for you, schedule a meeting with your healthcare provider to discuss alternatives, such as inhaled insulin or an automated insulin delivery system.
The bottom line
While injecting insulin can feel daunting, there are many different resources to help you master the technique. You can seek one-on-one support from your healthcare provider or a CDCES, or try a diabetes self-management education class to learn with others in a group setting.
Ultimately, Milsted said after the first injection, people tend to realize it’s not so bad – especially with modern technology, needles are now very small and discrete.
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