Diabetes: Giving yourself an insulin shot

Introduction

If you have type 1 diabetes—or if you have type 2 diabetes and oral medicines are not controlling your blood sugar—you have to take insulin. If you have gestational diabetes, you may need to take insulin if diet and exercise have not been able to keep your blood sugar levels within your target range.

With little or no insulin, sugar (glucose) in the blood cannot enter your cells to be used for energy. As a result, the sugar in your blood rises above a safe level. When your blood sugar rises past about 180 mg/dL, your kidneys begin to release sugar, which can make you dehydrated. If you are dehydrated, your kidneys make less urine, which means your body can't get rid of extra sugar. This is when blood sugar levels rise. If you can drink enough fluid to prevent getting dehydrated, you'll be able to release excess sugar in your urine.

Taking insulin can prevent the symptoms of high blood sugar and emergencies such as diabetic ketoacidosis (in type 1 diabetes) and hyperosmolar coma (in type 2 diabetes). Insulin also can help prevent serious and permanent complications from long-term high blood sugar.

Most people use insulin in an injection, or shot. It is given into the fatty tissue just under the skin. It also can be given through an insulin pump, an insulin pen, or a device that sprays the medicine into the skin (jet injector). Experts are studying other ways of giving insulin, such as in a patch or implantable pump. But this information is about insulin in syringes.

Once you get over the initial anxiety, giving yourself a shot will become a routine part of your day. It's quite easy to learn the basics of drawing the insulin up into a syringe and injecting it. Although never pleasant, the sting of the injection is not bad and does not last long. More than 500,000 people do it every day. You can, too.

The three most important elements of success in giving insulin injections are:

  • Making sure you have the right dose of insulin, especially if you are giving two types of insulin in the same syringe.
  • Practicing how to give your injection.
  • Storing the insulin properly so that each dose will work effectively.
 

Insulin for injection comes in small glass bottles (vials) and cartridges; both are sealed with a rubber lid. One bottle or cartridge contains many doses. To remove a dose of insulin from:

  • A bottle: You will use an insulin syringe. You will also use the syringe to inject the insulin.
  • A cartridge: You will use a pen-shaped device called an insulin pen. The cartridge fits inside the pen and the dose of insulin is set with a dial on the outside of the pen. The pen (with the cartridge inside) is used to give the medicine. Both disposable and reusable insulin pens are available. Each pen operates slightly differently.

Note: If you are using an insulin pen, talk with your doctor, pharmacist, or diabetes educator about how to use the pen properly. Giving insulin with these pens is not covered in this information.

To give an insulin injection, you insert the needle (attached to the syringe) into your skin. Push the plunger to inject the medicine into the fatty tissue just below the skin. Insulin usually is injected into the abdomen, upper arm, or thigh.

Your doctor may have you take two types of insulin at the same time. Because most types of insulin prescribed to be taken at the same time can be mixed together, you most likely will be able to give both doses in the same syringe. But you cannot mix the long-acting insulin glargine (Lantus) or insulin detemir (Levemir) in the same syringe with other types of insulin.

Test Your Knowledge

To withdraw a single dose of insulin from a bottle, I need to use a syringe.

  • True
    This answer is correct.

    To withdraw a single dose of insulin from a bottle, you do need to use a syringe.

  • False
    This answer is incorrect.

    To withdraw a single dose of insulin from a bottle, you do need to use a syringe.

  •  

To give an injection of insulin, the needle of the syringe is inserted into the skin and the medicine is pushed into the fatty tissue just under the skin.

  • True
    This answer is correct.

    To give an injection of insulin, the needle of the syringe is inserted into the skin and the medicine is pushed into the fatty tissue just under the skin.

  • False
    This answer is incorrect.

    To give an injection of insulin, the needle of the syringe is inserted into the skin and the medicine is pushed into the fatty tissue just under the skin.

  •  

Continue to Why?

 

Normally, insulin is produced by the pancreas. Insulin lets sugar (glucose) in the blood enter body cells, where it is used for energy. It helps the body store extra sugar in muscles, fat, and liver cells. Later, that sugar can be released if it is needed. Without insulin, the body cells cannot use sugar, causing the blood sugar level to rise above what is safe for your body.

You need to take insulin because you have:

  • Type 1 diabetes , which causes your body to produce little or no insulin. You have to take one or more types of insulin for the rest of your life.
  • Type 2 diabetes , which causes your body to require more insulin than it can produce. When your body starts producing too little or no insulin, you will have to take insulin for the rest of your life. You may need to take insulin for a short time if your body is under unusual stress, such as if you are having major surgery, are severely ill, or become pregnant.
  • Gestational diabetes . Your body is not able to use insulin properly. You will need to take insulin during your pregnancy if getting regular exercise and eating a balanced diet does not keep your blood sugar levels within your target range.

Test Your Knowledge

A person whose pancreas produces little or no insulin has to take insulin.

  • True
    This answer is correct.

    A person whose pancreas does not produce any or enough insulin has to take insulin. This includes people with type 1 diabetes, some people with type 2 diabetes, and some women with gestational diabetes.

  • False
    This answer is incorrect.

    A person whose pancreas does not produce any or enough insulin has to take insulin. This includes people with type 1 diabetes, some people with type 2 diabetes, and some women with gestational diabetes.

  •  

People with type 2 diabetes who are under unusual stress, such as having major surgery, may need to take insulin for a short period of time.

  • True
    This answer is correct.

    People with type 2 diabetes who are under unusual stress, such as having major surgery, may need to take insulin for a short period of time.

  • False
    This answer is incorrect.

    People with type 2 diabetes who are under unusual stress, such as having major surgery, may need to take insulin for a short period of time.

  •  

Continue to How?

 

Your health professional will help you learn to prepare and give your insulin dose. Here are some simple steps to help you learn this task.

Get ready

To get ready to give an insulin injection, follow these steps.

  1. Gather your supplies. You will need an insulin syringe, your bottle (or bottles) of insulin, and an alcohol wipe or a cotton ball dipped in alcohol. Most people keep their supplies in a bag or kit so they can carry the supplies wherever they go.
  2. Check the insulin bottle label and contents. When you use an insulin bottle for the first time, write the date on the bottle. On the 30th day after opening, throw away the bottle with any remaining insulin. Insulin may not work as well after 30 days of use.
  3. Wash your hands with soap and running water. Dry them thoroughly.

Prepare the injection

Your preparation will depend on whether you are giving one type of insulin or mixing two types of insulin.

If you have poor eyesight, have problems using your hands, or cannot prepare a dose of insulin, you may need someone to prepare your insulin injections ahead of time. See prefilling insulin syringes.

Prepare the site

Before giving your injection:

  • Choose the part of your body to inject. See the diagram of injection areas for where to give insulin injections. If you give your injections in different places on your body each day (rotate sites), use the same site at the same time of the day. For example, each day:
    • At breakfast, give your insulin into one of your arms.
    • At lunch, give your insulin into one of your legs.
    • At dinner, give your insulin into your abdomen.
  • Clean the site. If you use alcohol to clean the skin before you give the injection, let it dry.
  • Relax your muscles in the area so the injection will be less painful.

Give the injection

Follow these steps for giving an insulin injection.

  1. Slightly pinch a fold of skin between your fingers and thumb of one hand.
  2. Hold the syringe like a pencil close to the site, keeping your fingers off the plunger. Usually the syringe is at a 90-degree angle to the skin site. If you are a thin adult, you may want to insert the needle at a 45-degree angle.
  3. Bend your wrist and quickly push the needle all the way into the pinched-up area. Then let go of the pinched-up area.
  4. Push the plunger of the syringe all the way in so the insulin goes into the fatty tissue. Wait a few seconds to make sure the insulin gets into the tissues.
  5. Take the needle out at the same angle that you inserted it. If you bleed a little, apply pressure over the injection site with your finger, a cotton ball, or piece of gauze. Do not rub the area. Check your blood sugar more frequently on the days when bleeding occurs.
  6. Replace the cover over the needle. Although syringe manufacturers do not recommend it, some people reuse their syringes until the needle becomes dull or bent. If you plan to reuse your syringe, see precautions when reusing syringes.

View the slideshow on giving an insulin injection into the stomach to see photographs of an injection.

Cleanup and storage

After giving your injection, be sure to:

  • Store your insulin properly so that each dose from the bottle will work effectively.
  • Dispose of your used syringe. Do not throw your used syringe and needle into a household wastebasket or trash can. You can dispose of them in a metal container, such as a coffee can, that has a lid that screws on or that you tape down tightly. You also can buy special containers for disposing of used needles and syringes. You can also buy a small needle clipper device that breaks the needle off the syringe and stores it safely for disposal. Talk with your local trash disposal agency, pharmacy, or your health professional about how to get rid of the container.

Other tips for success and safety

  • Do not mix other medicine with insulin without your doctor's instruction; some types of insulin cannot be mixed together. See precautions when mixing insulin for more information.
  • Never share syringes. Syringes should never be shared with another person because of the risk of getting diseases that can be transferred through blood, such as acquired immunodeficiency syndrome (AIDS) or infection of the liver (hepatitis).

Test Your Knowledge

The first step in preparing insulin from a bottle is to roll the bottle gently between your hands.

  • True
    This answer is correct.

    The first step in preparing insulin from a bottle is to roll the bottle gently between your hands. This will warm the insulin if you have been keeping the bottle in the refrigerator. Roll a bottle of cloudy insulin until the white powder has dissolved.

  • False
    This answer is incorrect.

    The first step in preparing insulin from a bottle is to roll the bottle gently between your hands. This will warm the insulin if you have been keeping the bottle in the refrigerator. Roll a bottle of cloudy insulin until the white powder has dissolved.

  •  

When you are preparing a cloudy and a clear insulin to give a mixed dose, which do you put into the syringe first?

  • Cloudy insulin
    This answer is incorrect.

    When you are preparing a cloudy and a clear insulin to give a mixed dose, you put the clear insulin into the syringe first.

  • Clear insulin
    This answer is correct.

    When you are preparing a cloudy and a clear insulin to give a mixed dose, you put the clear insulin into the syringe first.

  •  

Continue to Where?

 

Now that you have read this information, you are ready to start preparing and giving insulin injections.

Talk with your doctor or diabetes specialist

If you have questions about this information, take it with you when you visit your doctor or diabetes specialist. You may want to mark areas or make notes in the margins on the pages where you have questions.

If you would like more information on preparing and giving insulin injections, the following resources are available:

Organization

American Diabetes Association (ADA)
1701 North Beauregard Street
Alexandria, VA  22311
Phone: 1-800-DIABETES (1-800-342-2383)
E-mail: AskADA@diabetes.org
Web Address: www.diabetes.org
 

The American Diabetes Association (ADA) is a national organization for health professionals and consumers. Almost every state has a local office. ADA sets the standards for the care of people with diabetes. Its focus is on research for the prevention and treatment of all types of diabetes. ADA provides patient and professional education mainly through its publications, which include the monthly magazine Diabetes Forecast, books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also provides information for parents about caring for a child with diabetes.


More information about diabetes can be found in these topics:

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Last Updated: December 9, 2009

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