Insulin: How to Use and Where to Inject

You give yourself insulin as a shot (injection). It's injected in the fatty layer under the skin (subcutaneous). Some people use an implanted device called an insulin pump. Others inject insulin using prefilled pens. Your health care team will teach you how to use insulin. Make sure you follow all instructions about when and where you use it.

• Insulin is most often injected in belly (abdominal) fat. That's where it's absorbed fastest.
• Change the injection site each time you give yourself insulin. This helps prevent problems.
• Plan out how you'll move from site to site.
• Leave at least 2 inches around your belly button (navel).

Ask your health care provider to teach you about rotating your injection site. This will help prevent a bump from forming under the skin from using the same spot. Also ask how to prevent injecting it into the muscle. Injecting into the muscle or into the bump can lead to incorrect insulin absorption.

• Follow your doctor's instructions about when to give yourself insulin.
• It's very important to time your insulin shots with meals or snacks. Think about using the same part of the body for injecting insulin at the same time each day. For instance, you could always use your abdomen for morning injections and your legs for afternoon injections.

• Wash your hands. Use soap and clean, running water.
• Check the expiration date on the insulin. Don't use expired insulin.
• Look at the insulin. Clear insulin shouldn't be discolored or have crystals. Cloudy insulin shouldn't have clumps or crystals stuck to the side of the vial or pen.
• Let the insulin bottle reach room temperature before injecting.
• Wipe the top of the insulin bottle (vial) with alcohol.

1. Pull back the plunger until the end of the plunger is even with the number of units of insulin you take. Always read the number of units of insulin at your eye level.
2. Put the needle into the top of the bottle. Then push the plunger in all the way. This pushes air into the insulin bottle.
3. Turn the bottle and syringe upside down. The bottle will be on top.
4. Hold the needle and bottle straight up and down. Check that the needle is in the insulin.
5. Pull back on the plunger until the end of the plunger is even with the number of units of insulin you take.
6. Remove the needle. Then tap the syringe with a fingertip to remove any air bubbles.

Important: Some insulins shouldn't be mixed. Always check with your doctor before mixing insulin.

1. Before you start, add up the 2 insulin doses. This is so that you will know the total of the 2 doses. For instance, you need 6 units of regular (clear) insulin and 7 units of NPH (cloudy). Your total will be 13 units.
2. Pull back the plunger until the end of the plunger is even with the number of units of insulin you take. Always read the number of units of insulin at your eye level.
3. Put the needle into the top of the bottle. Then push the plunger in all the way. This pushes air into the insulin bottle.
4. If you use both regular and NPH insulin in a single syringe, carefully remove the needle from the first bottle. Repeat the above steps for the second bottle.
5. With both bottles prefilled with air, you're now ready to draw up the insulin. Always draw up regular (clear) insulin before NPH (cloudy). Put the needle in the bottle of regular (clear) insulin.
6. Turn the bottle and syringe upside down. The bottle will be on top.
7. Hold the needle and bottle straight up and down. Check that the needle is in the insulin.
8. Pull back on the plunger until the end of the plunger is even with the number of units of regular insulin you take.
9. Remove the needle from the regular (clear) insulin. Insert it into the NPH (cloudy) insulin bottle. Be careful not to push on the plunger.
10. Turn the bottle and syringe upside down. The bottle will be on top.
11. Hold the needle and bottle straight up and down. Check that the needle is in the insulin.
12. Pull back on the plunger until the end of the plunger is even with the total number of units you're taking. This number is the total of the 2 insulin doses together as shown in step 1 above.
13. Remove the needle. Then tap the syringe with a fingertip to remove any air bubbles.

• Wash your hands with clean, running water and soap for 20 seconds.
• Gently pinch up about 1 inch of skin. Don't squeeze the skin. Pinching up the skin may not be needed for certain body types or if you're using a shorter needle. Ask your doctor if you should pinch up your skin for the injection.
• Put the needle straight into the skin, at a right (90-degree) angle. A 45-degree angle may be better for very thin people and children. Ask your doctor which angle is best for you.
• Push in the plunger. Press until the syringe is empty. Let go of the skin. Then remove the needle. Don't rub the site after you remove the needle.
• Wash your hands again when you're done.

• Put the needle and syringe in a sharps container. Don't recap the needle.
• You can buy a sharps container at a pharmacy or medical supply store. Or you can also use an empty laundry detergent bottle or any other puncture-proof container and lid.
• When the sharps container is full, put it into a garbage bag and secure the top. Label the bag “needles” or “sharps.”
• Call your local waste company to ask about removing the sharps container. You can also check with the Coalition for Safe Community Needle Disposal at www.safeneedledisposal.org or 800-643-1643.

• Keep unopened insulin bottles in the refrigerator. An open bottle can be stored at room temperature, such as on the kitchen counter. But don't let the insulin get too hot. Always keep it below 86°F (30°C). And never let it freeze.
• Always use insulin before the expiration date on the bottle. Throw expired bottles away.
• Use insulin within 28 days of opening the bottle. After 28 days, throw it away. To remember, write the date you opened it on the bottle.
• When you travel, take all of your diabetes supplies. Put them in a bag made to protect insulin from heat and cold. Always keep them with you. Then you'll have what you need if there's a delay or your suitcase is lost.
• Never leave insulin in the car. It can get too hot or too cold.