How to Give an Insulin Injection
Note: This information is for educational purposes only and is not medical advice. For specific guidance on giving an insulin injection, please talk with your doctor.
We all grew up with some dread about those occasional visits to the doctor— and usually, it was that fear of getting a shot. Injections can seem intimidating at first, but practice makes perfect. Whether you are learning to inject for the first time using a pen or via a syringe, there are a few steps to keep in mind to master the art of giving an injection.
We know you may have reservations and a heightened fear at pricking yourself or your loved one. Remember though, that insulin injections are subcutaneous, meaning the area between the skin and the muscle, so the needles are usually smaller and shorter than you’re imagining.
Make sure you know what type of insulin you’re taking and how much. Is it a day’s worth of long-acting insulin? Or a meal coverage of rapid insulin? Since pens can look and feel similar to one another, double-check to avoid any mix-ups.
It’s also important to be certain of the condition of the insulin you’re using. For good insulin pen storage practices, check out our piece on insulin and temperature.
Check your insulin
Insulin has an expiration date, so be mindful of this and don’t use expired insulin. Insulin also can’t be stored in the freezer, or left in direct sunlight. If you were keeping it cool in a bag or the refrigerator, give it time (30 minutes) to warm up to room temperature. Once you open a vial or pen, you can keep at room temperature for around 28 days.
You’ll want to make sure there are no “clumps” inside the bottle of insulin. Sometimes this can happen when a bottle is shaken around too much, so if you spot any, don’t use that bottle and get another.
Depending on the type of insulin, you may need to gently mix it. “Short-acting” insulin is clear and does not need to be mixed. “Intermediate” or “long-acting” insulin does need to be mixed and usually appears cloudy. Gently rolling the bottle or pen between your palms for a few moments will do the trick, but remember not to shake it.
Get everything you need
- Syringe, with needle or needle tip for pen
- Alcohol swabs – You’ll want to wipe off the top of the bottle or pen, as well as the skin around the injection spot.
- A “sharps” container, which is basically any sturdy box with a lid where you can keep the used needles and syringes. There are rules about how and where you can dispose of these, so check in your area for what is most convenient for you. Keep in mind that you may need a specific type of container depending on which disposal option you choose.
Wash your hands
Don’t get lazy and skip this … who knows what invisible bacteria or viruses have collected on your apparently clean fingers, and minimizing germs before puncturing your loved one is the best way to reduce the chance of skin irritation or infection.
Pick an injection spot
You want to inject an area of fat, not muscle, and there are several common areas for injections (the abdomen, upper legs or thighs, or the back of the arms). It’s important to rotate your injection spots—always at least one inch from your last, one inch from any scars, and two inches from the navel. It may help to keep track of injection site in order to avoid a buildup of scar tissue.
Avoid any spots that are swollen or bruised. Make sure the skin is clean, and you can wipe this area with alcohol to make sure. Remember to let the alcohol dry before you inject, but don’t try to speed it up by blowing on it. (You want fewer germs, not more.)
After you pop the cap off and give the top a quick wipe with the alcohol, set the bottle on a flat surface. Grab your syringe and then pull back the plunger (filling it with air) to the amount you plan to inject. Then insert it down into the bottle and press the plunger down. This will push air into the bottle, which will add pressure and make drawing the insulin a bit easier.
Turn the bottle upside down and draw the plunger on your syringe back until you have the proper amount. You do not want any air bubbles in your syringe, so give it a little tap or push some back up into the bottle to make sure. Double-check that you still have the correct dosage in your syringe afterward.
Pull out the syringe; set it down with the bottle. And please—don’t touch anything with the needle and contaminate it.
If using an insulin pen, take a needle and remove the plastic covering on the base (on the opposite end of the “needle” part). Align the base of the needle onto the pen and twist until it sits snugly on there, but not too tightly. Then remove the protective cap from the needle itself.
The key to minimizing the pain of an injection is speed—no waggling the syringe after you make contact. Some other tips include making sure your insulin is at room temperature (there’s more discomfort when it’s cold) and relax muscles before injecting.
Pinch a hunk of flesh around where you want to give the shot. This should give you an area with enough fatty tissue underneath, so you’ll want to aim straight down (at a 90-degree angle) into the skin, but if you or your loved one is lean and there’s not much flab there, keep the needle at a slight (45 degree) angle instead. Remember, you want to avoid muscle, and doing so will also be less painful.
Calculate your dose and dial the amount on the pen.
Hold the syringe firmly and then bring it down with a quick motion. Don’t overthink it—just jab the needle all the way in. Now let go of the skin, push down the plunger on the syringe or button on the pen to inject the insulin, and then wait 5-10 seconds before pulling the needle out (at the same angle you poked it in).
If there’s a little insulin leak or a bit of blood from the injection site, press down on the area but avoid rubbing it. You can use a cotton ball or a wipe, and even a small bandage if you like. If this happens consistently or if redness or swelling after an injection develops, then mention it to your/their doctor for further advice.
Needles and syringes are single-use, so place the plastic cap back on the pen needle and twist (counter-clockwise) to separate the needle from the pen and ditch the needle or syringe in your sharps container. Never reuse either.
Put the pen cap back on. If this is your first time opening a particular pen, try writing the date on a small piece of tape with a Sharpie and wrapping it around the pen cap or the pen itself (taking care not to cover the dosing measurements or the little window to preview the insulin) to keep track of how long the pen has been in use.