Diabetes treatment: Tips for injecting insulin and preventing problems

When you're first told that your diabetes treatment plan will include taking insulin, it's normal to feel nervous about giving yourself insulin injections. Whatever insulin regime you're prescribed, it can become less daunting and more comfortable the more familiar you become with how to properly inject insulin.

If you're uncertain about giving yourself insulin injections, here are some tips to improve your skills and to prevent common problems associated with insulin. You can also brush up on your technique by viewing the video on how to inject insulin.

Giving yourself insulin

The most common way to inject insulin is with a syringe and needle. You withdraw insulin from a bottle into a syringe; then inject the medication underneath your skin where it's absorbed into your bloodstream.

Insulin may be injected into any area of your body where a layer of fatty tissue is present and where large blood vessels, nerves, muscles and bones aren't too close to the surface.

Insulin is best injected into the abdomen because of quick and consistent absorption. Avoid the 2-inch circle around the navel, which doesn't absorb as well. Rotate the site of each injection as shown in the illustration. Your doctor or diabetes educator may recommend alternative areas for injection, such as the back of your upper arms, thighs or buttocks.

Avoiding skin irritation at the injection site
Occasionally — especially when you first use insulin — you may notice redness and some slight swelling at the injection site. This may result from impurities in the insulin or could stem from a small amount of alcohol getting into the underlying tissue. To avoid this, let the injection site thoroughly dry if you clean it with alcohol.

If skin irritation lasts more than two to three weeks or causes discomfort, talk to your doctor or another member of your diabetes care team. To minimize pain from injections:

• Make sure the insulin is at room temperature.
• Relax your muscles in the area of the injection.
• Penetrate the skin quickly with the needle.
• Don't change the direction of the needle during the injections.

Some people develop indentations, hard lumps or thickened skin in areas where they inject insulin. Avoid injecting in these areas because the insulin won't be absorbed well. Rotating the site of your injections usually prevents or reduces this problem.

Insulin injection sites

Insulin injection sites

Generally the abdomen is the best injection site. Rotate the site of each injection. The upper arms and thighs (shaded areas) as well as the buttocks also are potential injection sites.

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Preventing other common insulin problems

Injecting insulin that's out-of-date or contaminated with bacteria can lead to high blood sugar (hyperglycemia) or cause an infection at the injection site. To reduce your risk of problems from insulin use:

• Buy all of your insulin from the same pharmacy. This helps ensure that you receive insulin from the same source and of the same type and concentration, unless your doctor advises a change. Check the expiration date on the package and always keep a spare bottle on hand.
• Store your insulin in the refrigerator until it's opened. Let the insulin warm up to room temperature before you inject it, because cold insulin can cause discomfort when injected. After a bottle has been opened, it may be kept at room temperature for one month. Throw away your insulin after the expiration date or after being kept at room temperature for a month.
• Avoid temperature extremes. Never freeze insulin or expose it to extremely hot temperatures or direct sunlight.
• Look for changes in appearance. Throw away insulin that's discolored or contains solid particles.
• Wear diabetes identification. Wear an identification necklace or bracelet that identifies you as an insulin user. In addition, carry an identification card that includes the name and phone number of your doctor and all the medications you're taking, including the kind of insulin. In case your blood sugar drops too low, this helps co-workers and others know how to respond.
• Speak up. To avoid possible drug interactions or drug side effects, inform your dentist, pharmacist and those doctors that may not be familiar with your medical history that you take insulin.
• Check all medications. Before taking any medication other than your insulin, including over-the-counter products, read the warning label. If the label says you shouldn't take the drug if you have diabetes, consult your doctor before taking it.
• Get help for allergic reactions. In rare instances, insulin injections may cause you to experience breathing or swallowing problems. If this occurs, you may be having a potentially life-threatening allergic reaction called anaphylaxis. This is a medical emergency — call 911 or go to an emergency room immediately.

Staying in control

Follow your doctor's recommendations for taking insulin. Giving yourself insulin doesn't have to be difficult. Contact a member of your diabetes care team if you're uncertain about your insulin regime. By becoming comfortable at giving yourself injections and avoiding common problems, taking insulin will become part of your care routine that helps you stay in control of your diabetes.

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