Insulin Injections

Recently Answered

• QHow should I put insulin into a syringe?

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  A Intermountain Registered Dietitians , Nutrition & Dietetics, answered on behalf of Intermountain Healthcare

  "Drawing up insulin" means putting the insulin in the syringe for an injection. To get the right dose and to reduce the pain of the injection, follow these steps carefully:
  
  1. Get everything you need: insulin bottle, syringe, alcohol wipe, and your daily record log to write down the dose. (A log book is included with your blood glucose meter.)
  2. Wash your hands with soap and water.
  3. Write down the dose of insulin in your daily record.
  4. Check the insulin. First, make sure you've got the right bottle (the right type of insulin). Second, check the insulin for any discoloration, cloudiness, or sediment (stuff sitting on the bottom or floating around inside). If you see any of these, throw the insulin away and use new insulin.
  5. Wipe the top of the bottle with an alcohol wipe.
  6. Pull back the plunger on the syringe to draw in enough air to equal your insulin dose (use the lines and numbers on the barrel of the syringe), then push the needle into the bottle and inject the air into the bottle. (This prevents the vacuum inside the bottle from sucking the insulin back out of the syringe.)
  7. With the needle in the bottle, turn the bottle and syringe upside down. First draw up insulin past your correct dose. Then, slowly push on the plunger to the line of your correct dose of insulin.
  8. Before withdrawing the needle from the bottle, check for air bubbles. If you notice any, tap the syringe so that the bubbles float to the top. Pull the plunger past your dose again and slowly push in the plunger until all bubbles are gone. Repeat as needed to get rid of air bubbles, then withdraw the needle from the bottle.
  9. If the insulin has been stored in the refrigerator, warm the syringe by holding it in your closed hand for a minute or so. Injections hurt less if the insulin is warm.
• QWhy do people fear insulin treatment?

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  A Dr. Jack Merendino, MD , Endocrinology Diabetes & Metabolism, answered

  You are going to be surprised by my answer, but I can assure you that I am right. I have started insulin on thousands of people during my career and I have lectured or spoken to tens of thousands more about this, so I know what I am talking about!
  
  Most people assume that it is the injections that make people afraid of insulin. That’s true sometimes -- I won’t try to deny it -- but that’s not the big issue for most people. Even when it is the big concern, once you have them do just one or two they lose most of their anxiety about the shots because they are almost painless.  
  
  The real reason people fear insulin is all psychological. In the minds of most people, if they are on oral diabetes medication, they assume they don’t have a very serious problem. “I have a touch of sugar” is a phrase you still hear in many areas of the country, and it sounds almost quaint. In contrast, people think that if they are on insulin, they must have a serious medical problem. They fear being told that they have to take insulin because they are afraid this means that they have moved from a minor medical issue to something that is going to cause them real trouble.  
  
  The irony here, of course, is that what makes diabetes frightening are the problems that occur when it is not well-controlled, and insulin does a superb job of controlling diabetes when it is used correctly. A person who is on pills but has poor control of his her diabetes has a much more serious problem on their hands than a person who is on insulin but has near-normal blood sugar readings. The anxiety is so deeply-ingrained that simply being told that this is true is often not enough to help some people overcome their fear of starting insulin therapy. It can be a real challenge to persuade someone that it is the right thing to do. The silver lining is that once they start insulin most people realize how wrong they were in their beliefs and they quickly come to see how smart they were to overcome those feelings and start insulin.
• QHow long does insulin work after injection?

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  A Dr. Jack Merendino, MD , Endocrinology Diabetes & Metabolism, answered

  Insulin is usually classified as short- or fast-acting, intermediate-acting and long-acting. Short-acting insulin typically begins to act within 30 to 45 minutes, reaches a peak of action at around 90 minutes and has mostly stopped working by about 3 to 4 hours. Short-acting insulin includes a generic form called “regular” insulin and the brand-name insulins Humalog, NovoLog and Apidra. There is also a short-acting form of insulin that is inhaled rather than injected. This was introduced in 2015 under the brand name Afrezza. Short-acting insulin is used to treat the rapid rise and fall of sugar with meals.  
  
  Intermediate-acting insulin, most commonly a type known as “NPH,” typically starts to work somewhat more slowly, reaches a peak of action within about 6 hours and lasts between 12 and 18 hours in most people, though there is lots of variability from one patient to another. This kind of insulin is not used as commonly now as it had been but still works well in some settings.  
  
  Long-acting insulin is meant to provide a background of insulin throughout a 24-hour period. A long-acting insulin, glargine, comes as brand-names Lantus and Toujeo. A generic form will likely become available in 2015 or 2016. Another form of long acting insulin called detemir insulin comes as brand-name Levemir.  
  
  People with type 1 diabetes must either taking short-acting insulin round-the-clock in an insulin pump or they can take a long-acting form of insulin as a background and inject additional fast-acting insulin with meals.  
• QWhat is an Inject-Ease?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Inject-Ease is the brand name of a type of automatic injector that helps you give insulin shots. It’s a spring-loaded device that holds the syringe and needle, and can be used with just one hand. It keeps the needle out of sight, making it useful for those with needle phobias. It may reduce the pain of injections and is helpful for those inexperienced at giving shots.

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• QHow do I use an insulin pen?

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  A William Lee Dubois , Endocrinology Diabetes & Metabolism, answered

  To use an insulin pen to inject your insulin:
  
  First, screw the space capsule onto the insulin pen.
  
  Once it is on, pull the milky white plastic part off.
  
  Now you’ll see a pencil lead-like piece of plastic. It might be white, it might be purple, depending on the brand and size of the needle. That’s the needle cover. Pull it off carefully, being sure not to bend it to either side. Now you’ll see a ridiculously small needle.
  
  Have no fear.
  
  Spin the dial on your pen to “1” or “2” and do what we call an “air shot.” Make sure you get a little squirt of insulin or a drop at the tip of the needle.
  
  Now, dial up your dose. Hold the pen perpendicular to your skin. Slide it in. Inject. Count ten seconds in your head…
  
  You are done.
  
  Pull the needle out of your body and replace the little cap, being careful not to bend the needle.

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• QHow can I safely reuse insulin syringes if I have diabetes?

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  A American Diabetes Association answered

  Here are some tips to keep in mind when reusing insulin syringes:

  • Keep the needle clean by keeping it capped when you're not using it.
  • Never let the needle touch anything but clean skin and the top of the insulin bottle.
  • Never let anyone use a syringe you've already used, and don't use anyone else's syringe.
  • Cleaning it with alcohol removes the coating that helps the needle slide into the skin easily.
• QWhat do I need to know when buying syringes for my insulin?

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  A American Diabetes Association answered

  The syringe consists of a needle, barrel, and plunger. Syringes come in different sizes. It is important to match the size of the syringe to the dose you’ll take with it. You want a syringe that will hold your entire dose of insulin. For example, if you need to take 45 units of insulin, you would want to use a 50-unit syringe to hold all your dose. A 30-unit syringe (the next smallest size) is handy for giving yourself injections of 30 units or less. Likewise, if you need to inject very small doses of insulin, 1/2 unit for example, use syringes that have 1/2 unit marks to keep doses accurate.
  
  Also, check to see whether you can read the markings on your syringe. A 100-unit syringe holds 100 units of insulin in a volume of 1 cc (or 1 ml). Each line marks 2 units of insulin. A 50-unit syringe holds 50 units of insulin in 0.5 cc of liquid, and each line marks 1 unit. A 30-unit syringe holds 30 units of insulin in 0.3 cc, and each line marks 1 unit. You will need to measure out each dose in units. So, if you can’t see the lines marked on the syringe, you will have problems getting an accurate dose. There are devices you can buy to make it easier to read the markings on the syringe. Your pharmacist or diabetes educator can tell you what supplies are available to help you.
  
  Another good source of information is the American Diabetes Association Consumer Guide published yearly by Diabetes Forecast, the members’ magazine of the American Diabetes Association. The Consumer Guide is also available online at forecast.diabetes.org/consumerguide.
• QWhat is an automatic injector for insulin use?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  An automatic injector is a tool to help you give an insulin injection. It’s a spring-loaded device that holds the syringe and needle. Some injectors can be used with just one hand. These devices are useful for people with needle phobias or who are visually impaired or inexperienced at giving injections.

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• QHow should I inject myself with insulin?

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  A Intermountain Registered Dietitians , Nutrition & Dietetics, answered on behalf of Intermountain Healthcare

  You need to inject insulin just below the skin, into the fat layer -- not into a muscle or a blood vessel. This makes sure that the insulin works in the right way in your body. Here are the basic steps for injecting insulin:
  
  1. Choose the place on your body where you will inject the insulin. This area is called the injection site.
  2. Make sure the area is clean. If it isn't, wash it with soap and water. As a general rule, don't use alcohol to clean the site. This dries and toughens the skin. Of course, if you're camping or someplace where you can't wash, it's okay to use an alcohol swab.
  3. Lift up (pinch) about an inch of the skin and fat tissue with your thumb and fingers.
  4. Holding the syringe like a pencil, touch the needle to the skin, then push it into the skin. Push it straight in, not at an angle -- and make sure the needle is in all the way. You might feel a sting.
  5. Once the needle is in the skin, let go of the pinch of skin.
  6. Push the plunger of the syringe down slowly and steadily, all the way.
  7. When the plunger is all the way down, count to 5 slowly before removing the needle. This helps prevent insulin from leaking out of the site.
  8. Press your finger over the site for a few seconds. This helps stop any bleeding that can happen when you pull out the needle.
• QWhat are diabetic needles and syringes?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Diabetic needles and syringes allow you to administer injectable liquid insulin to yourself. If your doctor has prescribed insulin injections, a nurse or other healthcare professional will explain how to use diabetic needles and syringes properly.
  
  Diabetic needles come in various sizes and lengths. As the gauge or thickness of the needle increases the length decreases so that a needle with a higher gauge will be thinner. Gauge 31 is the thinnest insulin needle currently available. In general, thinner and shorter needles cause less pain during injection.
  
  The length of needle depends on your body shape and type. The most commonly used needle is a half-inch long, but children usually use a 3/16-inch needle. If you are overweight you may require a longer needle so that it can penetrate far enough under the skin to administer the correct amount of insulin.
   
  Syringes also come in different sizes to accommodate specific doses of insulin. The most common dosage of insulin is 100 units per milliliters of fluid (or, U-100) and is injected using a U-100 syringe. Regardless of size, the syringe will have a plunger that allows you to draw and inject the medication.
  
  If your diabetic needles and syringes can be reused, always sanitize them before using them again. Don’t reuse a disposable needle or share needles because of the risk of infection.