How to Inject Insulin Correctly

Introduction: diabetes is a chronic disease caused by the body's inability to produce or use insulin. Insulin is a substance produced in the body by the pancreas, and it enables the body to use sugar.

Impaired or absent insulin secretion by the pancreas, or insulin not working properly, or both, cause high blood sugar (hyperglycaemia) and other metabolic disorders; if hyperglycaemia is not well controlled, it may lead to serious complications. Types of insulin: regular insulin, which is clear and fast-acting and acts on the sugar from meals.

NPH insulin, which is milky and intermediate-acting; it is not linked to the food you eat, but provides the insulin the body needs over 24 hours.

Care needed when storing and using insulin

1. Keep the insulin you are using in a cool place, and do not let it freeze.
2. Do not inject insulin that is past its expiry date, and always check the insulin for clarity before use.
3. Inject insulin at a set time every day, before your main meal.
4. Do not inject cold insulin. Before drawing up the insulin, gently roll the vial between the palms of your hands, and first disinfect the point where the needle goes in with cotton wool soaked in alcohol.
5. Your insulin dose must be adjusted by your doctor; never increase or decrease your insulin dose on your own.
6. If you need to use two types of insulin (regular and NPH), draw the regular insulin into the syringe first, then the NPH insulin.
7. First disinfect the injection site with cotton wool soaked in alcohol and let it dry completely, then inject the insulin.
8. Inject insulin under the skin, into the fatty tissue. Change the injection site regularly; injecting in the same place again and again will make the skin there hard.

• Insulin is absorbed faster through the skin of the abdomen than through the skin of the thigh
• Inject insulin into your abdomen in the morning and into your thigh at night
• The four main sites for injecting insulin are:

1. The abdomen
2. The skin of the upper arms
3. The buttocks; the front of the thighs

How to inject insulin correctly

1. If you are using NPH (cloudy) insulin, roll the insulin vial between your hands several times so that the crystals in it mix evenly.
2. Draw air into the syringe equal to the prescribed amount of insulin.
3. Push the air you have drawn into the syringe into the insulin vial.
4. Now hold the insulin vial uppermost, with the syringe pointing downwards.
5. So that you can remove the air from the syringe afterwards, first draw 3–4 units more insulin than the prescribed amount into the syringe. To remove the air, tap the syringe gently a few times, then slowly push the extra insulin and the air in the syringe back into the insulin vial.
6. With your thumb and index finger, gather up part of the skin at the injection site (as if pinching it).
7. In the same place where you have gathered up the skin, insert the needle into the skin straight (vertically) or at a 45-degree angle, then push the plunger all the way down, so injecting the insulin into the tissue.
8. Withdraw the needle from the skin and hold cotton wool on the injection site for a few seconds. Insulin pen: a newer way of injecting insulin is to use a pen, which looks like a (fountain) pen. There are two types of pen on the market:

1. Pens that cannot be refilled (disposable pens)
2. Pens that can be refilled (refillable pens). To get the best use out of a pen, it is very important to know the different parts of the insulin pen.

Pen cap: protects the insulin cartridge and makes the pen easy to carry. Pen needle: the part that is attached to the end of the pen; it must be changed at every injection or after several injections. Insulin dose selector: used to set the exact dose of insulin to be injected. Insulin cartridge: the part that contains the insulin – a clear container with a rubber stopper.

Setting the dose and injecting with an insulin pen

1. Set the chosen dose. If you have turned the dose dial to the wrong number of units, turn it back to the correct unit.
2. Inject the dose as instructed by your nurse or doctor.

Place the needle against your skin and press the injection button all the way in. As you inject, the number shown in the dose window goes down until it reaches “0”. Insulin may drip from the needle for a short time after you have pressed the injection button. After the button has been pressed fully in, keep it pressed in for 10 seconds to make sure the full dose has been delivered.

Prepared by: Mohaddeseh Ghasemi – Education Unit
Document code: NO-BR-10