Instructions on Insulin Injections With Needles

Diabetics often require additional insulin in their bloodstream to control blood glucose levels. Since the digestive system breaks down insulin, it must be administered by a subcutaneous injection. Subcutaneous (meaning below the skin) injections are much easier to perform than intravenous or intramuscular injections. Subcutaneous injections can be administered nearly anywhere on the body, but are most commonly done in the abdomen. This site is chosen because of its lack of nerve cells, meaning less discomfort, and faster rates of insulin absorption into the bloodstream.

Selecting a Syringe

• Obtain a new insulin syringe. While insulin syringes may be reused by the same user, most health care providers recommend one-time use. Each time a needle is reused, it will be less sharp than the previous, causing more discomfort.

  Never share a needle with others.

  Insulin needles are calibrated in units, and are available in different capacities. Make sure that your needle is large enough to hold your total dose of insulin.

  The finest needles available are 30-gauge needles. The finer the needle, the less discomfort you will feel.

Dosing

• Determine your proper dose of insulin as directed by your medical provider. Keep this number written down and do not trust it to your memory. Insulin overdose can be extremely hazardous, and out of range blood glucose measurements can cloud your memory.

  You may be directed to take more than one type of insulin at a time. Your medical provider may allow you to mix both in the same syringe to reduce the number of injections. However, there is normally a sequence of which type of insulin must be loaded into the syringe first.

  A syringe will have caps covering the plunger and needle. Remove both caps.

  Prior to drawing any insulin from the bottle, pre-charge the bottle with the same volume of air as the amount of insulin you will be drawing. Pre-charging will make it easier to draw the insulin out of the bottle.

  If your specified dose is 10 units, pull the syringe back until the top of the plunger is lined up with the "10" mark on the syringe. Push the needle through the rubber top of the insulin bottle, and press down to force 10 units of air into the bottle. Repeat this for all insulin types to be injected.

  While not generally recommended, you can swab the top of the bottle with an alcohol wipe prior to drawing the insulin. This is not generally viewed as a requirement, and the presence of alcohol on the needle will cause stinging upon injection. However, this is good practice if the bottle was dropped or in contact with sources of dirt. Swab the bottle top with one swipe and discard the alcohol wipe.

  Push the needle into the insulin bottle, and draw back until the plunger lines up with the specified dose. Pull back slowly to avoid any air pockets or bubbles.

  If there is a second type of insulin to be injected simultaneously, repeat the draw with the second insulin. The plunger will now need to be pulled back to a number representing the total dose.

  Replace the cap on the needle of the syringe.

Injection

• Choose a spot for the injection as directed by your medical provider. Insulin is most commonly injected into the abdomen in a band roughly 2 inches above and below the navel.

  Avoid injecting within 1 inch of the navel. Also avoid repeated injections at the same site.

  If desired, the site can be swabbed with an alcohol wipe prior to injection, although this is not commonly recommended unless the injection site appears dirty or contaminated.

  Remove the cap from the needle end of the syringe.

  Pinch 1 inch of skin, and position the needle directly above the bulge and at a right angle to the skin. Press the needle firmly into the skin until the needle is completely inserted. Press down on the syringe slowly and firmly, taking one second per 10 units of insulin injected. Insulin injected too fast can leak out after the needle is removed.

  If injected too quickly, insulin may burn and form a temporary lump under the skin.

  Remove the needle, replace the cover, and dispose of the syringe in an approved sharps container.

Other Considerations

• Certain types of insulin typically require some mixing prior to injection, while others should not be shaken. Consult your health care provider for specific recommendations. Mixing is best accomplished by rolling the bottle between both hands 20 times.

  Research has demonstrated that insulin can be injected through clothing without any loss of efficacy; however, more health care providers advise against the practice. If you are prone to bleeding at an injection site, blood-stained clothing can result.

  Many health providers recommend persons injecting insulin maintain current tetanus inoculations.

  Insulin should be kept refrigerated until injected.

  Insulin may be pre-loaded into a syringe and injected at a later time. It should be kept cool until injected. The insulin in the syringe should be stirred prior to injection. Roll the syringe between your hands 20 times.

  While it may seem intimidating, with a little practice, insulin injections become essentially painless.