Diabetes – Insulin injection techniques

Injecting insulin isn’t difficult, but takes some practice. Correct insulin injection technique isn’t uncomfortable, and allows your medication to work effectively.

Your doctor will show you how to inject insulin initially, but you can also follow these steps for successful self-injection.

• Set out your medication equipment
• Wash your hands.

Choose a suitable injection site:

• Stomach/abdomen: inject at least two fingers’ width from your navel, as there are many veins in this area.
• Upper and outer thighs: avoid injecting too near the bony area above the knee;
• Upper arms: choose the outer, back area, which has more fatty tissue

Don’t always choose the same place, as this can damage the tissue and cause lipohypertrophy (lumps under the skin). Using multiple injection sites, and rotating these, allows them time to heal.

• Try dividing each area into zones: abdomen – 4 zones, thighs – 2 zones, arms – 2 zones, buttocks – 2 zones. Use one zone each week, before moving to the next. Inject at least one finger’s width away from the previous injection.
• Don’t inject through clothing: needles are designed to enter skin only. It can also cause bruising, blood-stained clothing and needle contamination (clothes aren’t sterile).

If using a syringe, use a new sterile needle every time. Needle tips become blunt, hooked or broken off with repeat use. This can cause painful injections and skin damage, leading to lipohypertrophy at injection sites, which can block the needle and interfere with insulin absorption.

Wipe the top of the vial with alcohol first; let it dry. Draw up the correct amount of insulin in the syringe. Expel the air from syringe and needle.

If using a pen, attach a new needle and turn the knob to the correct dosage.

Pinch and lift 2.5cm of skin and fat with your thumb and forefinger. Insulin injections are subcutaneous i.e into the fatty layer just under the skin. Injecting too deep may reach the underlying muscle, which has more blood vessels, causing faster absorption of the insulin and making blood glucose levels drop too quickly. Using a shorter needle can help prevent injection into muscle.

• Insert the needle straight down, not at an angle.
• Inject the insulin or press the knob.
• Count slowly to 10 before removing the needle. Insulin may take slightly longer to come out of a pen than from a syringe.

Insulin shouldn’t drip from the needle: if it does, leave the needle in slightly longer next time.

• Dispose of the needle in a sharps container or use a needle cutter – never in a dustbin or toilet.

Insulin storage tips:

• Store unused pens in the fridge (2-8°C).
• Don’t freeze insulin.
• After opening an insulin vial, keep it at room temperature (15-25°C).
• If insulin overheats, discard it.
• When traveling, keep insulin in a cooler box with an icepack, covered with a towel to prevent it from getting too cold. Keep insulin in your hand luggage if traveling by bus or plane.

Suitable injection sites on the body:

• Stomach: inject at least two fingers’ width from your navel
• Upper, outer thighs: avoid injecting too near the bony area above the knee
• Upper arms: choose the outer area, which has more fatty tissue
• Buttocks