People with type 1 diabetes must take insulin to manage diabetes. Insulin is a liquid that is injected in the fat just under the skin. Some people with type 2 or gestational diabetes will also use insulin or another injectable medication in the GLP1 drug classification for blood glucose management. People with diabetes may inject one or more times a day. Here are a few things to consider about injections.
How insulin is delivered. Insulin can be delivered via syringe, an insulin pen, or an insulin pump. GLP1 medication is delivered by a pen-delivery system. While the delivery method may vary, the actual injection technique is similar.
Prepare. Whether using a vial and syringe or an pen-delivery device, examine the medication by holding it up to the light. Medication with clumps or an unexpected appearance should not be used. Make sure you have all necessary supplies and that the area and hands are clean. Sometimes there are small air bubbles inside the medication container. Small bubbles are not a problem. Larger bubbles may interfere with the accurate delivery of medication.
Selecting an injection site is the first step to receiving an injection. While it’s not uncommon to have a “favorite” spot to give an injection, it’s important to move injection sites around to avoid over using an area that could lead to developing lumps, bumps, or scar tissue. Thickening under the skin does not allow proper absorption of medication.
Tips for injection site selection:
- Insulin and GLP1 medications can be injected on the abdomen (a few inches away for the belly button), the outer thighs, the back of the arms, the upper buttocks or hips.
- Avoid repeatedly injecting the same location by allowing at least a finger width’s space between injections. This is called rotating sites.
Clean the skin at the selected site prior to the injection. While the site does not have to be sterile, it should be clean and then dry. Alcohol preps are convenient but may dry out the skin.
Deliver insulin into the fat tissue. To support a sub-cutaneous injection into fat tissue, sometimes the skin may need to be gently pinched between the thumb and index finger to avoid injecting medication into the muscle. The pinch-up is meant to put more distance between where the needle stops and muscle tissue. A longer needle length (6-mm or longer) increases the likelihood of needing to pinch-up the skin.
Inject needle at a 90-degree angle to the top of the pinched skin. Think of the syringe or insulin pen as a dart as you quickly and smoothly inject the needle. While you don’t want to “jab” the needle into the skin, you do want to make sure the needle is completely in the skin. Carefully reposition the hand so you can inject the insulin.
Inject the insulin. If using a syringe, push the plunger down until all the insulin is delivered. If using an insulin pen, press down on the delivery button until it stops. After injecting the insulin hold the syringe or insulin pen in the skin for 5 – 6 seconds to insure all the medication is delivered.
Remove the needle from the skin and dispose of it in an appropriate sharps container or a hard plastic container with a cap. The complete syringe will be thrown away or if using a pen-delivery device, only the needle needs to be disposed of.
No one looks forward to giving themselves an injection. Feelings of anxiousness are normal. Understanding the injection technique can ease concerns and produce successful outcomes.