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In the hospital and community we are frequently teaching patients how to inject insulin. Some a new starters and others simply need a refresher. However, if you start on insulin, it’s a must have skill.

Learning how to inject insulin is quite simple but will take some practice. There are 2 types of insulin pen. A cartridge where you keep the same pen but replace the cartridge and a disposable pen which you throw away once the insulin is finished.

Example of a disposable and cartridge insulin pen
Example of a disposable pen (left) and cartridge pen (right). Borrowed from https://www.ema.europa.eu/en/news/colour-change-insulin-injection-fiasp-avoid-mix-ups-tresibahttps://www.ema.europa.eu/en/news/colour-change-insulin-injection-fiasp-avoid-mix-ups-tresiba

If you prefer a video guide, I’ve borrowed diabetes UK’s video above. This will visually show you how to inject insulin if you are a more visual learner.

Prepping the pen

The first step when learning how to inject insulin depends on the type of insulin your using. Some types of insulin – such as intermediate or mixed insulins (Any insulin with an starting or ending with an ‘I” (e.g. Insulatard, Humulin I or with a number in it (Novomix 30, Humulin M3 – mixed) require a small shake of the pen. This is to help the insulin mix properly.

When I say shake, it’s really more of a gentle rotation of your wrist side to side. Try not to be too vigorous with this. Once this is complete we can start by prepping the pen.

Each injection requires screwing a needle onto your pen. The needles are only small and look like the imagine below.

Insulin needles for how to inject insulin

Remove the lid of the insulin pen and remove the film on the needle. The needle easily screws onto the insulin pen. It only screws in one direction so you can’t get this wrong.

Once screwed on, remove the needle cap. Keep hold of this because you’ll need it shortly. Some insulin pens have a second cap over the needle (the caps behind the needles as you can see in the picture above).

Remove this cap also and be careful not to prick yourself.

Air shot and dialling dose

Before you inject yourself you want to make sure there is no air in the needle.

On the opposite end of the pen to the needle is the dose dial. It looks like the imagine below.

Dial this to 2 units and push the button on the end of the pen to perform your air shot.

Air shot – borrowed from https://www.lantus.com/get-to-know-the-lantus-solostar-penhttps://www.lantus.com/get-to-know-the-lantus-solostar-pen

Make sure some insulin exits the needle. If this happens you’re now ready for your full dose. Should no insulin exit the needle after a couple of attempts, change the needle.

If all is ok with the needle, dial up your prescribed dose. This will be unique to you and it’s easy to turn the dial until it reaches the dose you requires.

Injecting the insulin

When injecting it is important to rotate your injections sites. I can’t stress this enough. Injecting persistently into the same area can cause fatty lumps to form under the skin which effects how the insulin is absorbed. This is a bad thing and we call these lipo’s.

You can inject into your abdomen section leaving an area of about a large coin around the belly button free. Then you can rotate all the way around to the area where the seams of your shirt would lie.

You can also inject into the fleshy part of skin at the top of your thigh. If you can reach, you can inject into the top of your buttocks and as a last resort, use the back of your arms (the bingo wings).

Insulin injection sites
Injection sites taken from https://www.lantus.com/using-solostar-insulin-penhttps://www.lantus.com/using-solostar-insulin-pen

Once you have your injection site, inset the needle into the site at a 90 degree angle. You may need to gently pinch the skin to help expose a bit of fatty tissue.

Slowly press down on the injection button until the dial gets to zero. You then need to count to 10 before removing the needle. This helps the insulin disperse properly into your skin and blood and thus prevents any leakage.

Final step – disposal of needle

Remember the needle cap I said to keep hold off, well we need it again to remove the needle.

This can be a bit fidley but it will only screw freely in one direction. Re-screw the cap onto the insulin pen. This will latch onto the needle. Then remove the cap once again by unscrewing it in the opposite direction and voila, you have completed your injection.

Sharps bin

You should have a sharps bin to dispose of your used needles. Never use the same needle twice because they become damaged with each use. This will increase the pain of injecting and increase the risk of infection.

Dispose of the needle into the sharps bin. Usually it is the local council who collects these and a quick Google search can tell you how this is done locally. If in doubt, speak with your diabetes team.

If you do not have a sharps bin, speak with your diabetes team or local council. It is dangerous to dispose of used needles in the regular waste bin.

Congratulations, you have performed your insulin injection.

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These give you real life strategies to manage your diabetes and help to prevent the risk of long term complications.

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