How To Inject Insulin
Before injecting insulin, be sure to check its quality. If it was refrigerated, allow your insulin to come to room temperature. If the insulin is cloudy, mix the contents by rolling the vial between your hands for a few seconds. Be careful not to shake the vial. Short-acting insulin that isnt mixed with other insulin shouldnt be cloudy. Dont use insulin that is grainy, thickened, or discolored.
Follow these steps for safe and proper injection:
Get The Insulin Pen Ready
Figure 4. Pull the pen cap off the insulin pen
Figure 5. Take off the protective tab
Figure 6. Twist the pen needle onto the insulin pen
Figure 7. Take off the outer needle cap
Figure 8. Take off the inner needle cap.
What Is Insulin And Why Do I Need It
Insulin is a hormone that controls the level of blood sugar in your body. People with diabetes may not have enough insulin or may not be able to use it properly. The sugar builds up in the blood and overflows into the urine, passing out of your body unused. Over time, high blood sugar levels can cause serious health problems.
All people with type 1 diabetes, and some people with type 2 diabetes, need to take insulin to help control their blood sugar levels. The goal in treating diabetes is to keep the blood sugar level within a normal range.
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How To Take An Insulin Injection
When your healthcare provider or diabetes educator teaches you how to give yourself an insulin injection, they may have you give yourself an injection in order to observe your technique and provide support. Once you get home and its time to give yourself an injection, you can follow these steps as a reminder. If your healthcare provider has given you individualized instructions, always follow them.
In general, the following steps cover how to take an insulin injection:
Before you begin, wash your hands and gather supplies, including your insulin vial or pen, a new pen needle or syringe, an alcohol swab, sharps container, and a magnifier if needed.
How to inject insulin using an insulin pen:
How to inject insulin with a syringe:
A note about mixing insulin: Some people mix two types of insulin in one syringe. Mixing insulin in a syringe requires specific steps, and you will want to meet with your healthcare provider or diabetes educator to ensure that that you are accurate in dosing your insulin.
Storage and disposal tips:
Dispose of used pen or syringe needles safely so that no one gets an unwanted stick. Pick up a sharps container at the pharmacy, or make your own with a sturdy detergent container or similar plastic jug. Once the container is ¾ full, tape the top back on securely and contact your town to see if they have a sharps program for proper disposal. For more information on sharps disposal follow these guidelines from the FDA.
What Is Different About Insulin Lispro
Insulin lispro is a new type of insulin. It starts working sooner than other insulin types. It also reaches peak activity faster and goes away sooner. Insulin lispro helps keep your blood sugar level from going too high after you eat. To keep your blood sugar level steady, your doctor will probably prescribe either a longer-acting insulin or another drug for you to take each day in addition to the insulin lispro.
If you need to mix insulin lispro with a longer-acting insulin, it’s best that you mix insulin lispro only with Humulin U or Humulin N, which are brand names for certain longer-acting insulins. Insulin lispro should always be drawn into the syringe first. This will keep the longer-acting insulin from getting into the insulin lispro bottle.
Types of insulin
Each type of insulin works at a different speed and lasts for a different length of time.
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Quick-acting, such as insulin lispro , begins to work very quickly and lasts for 3 to 4 hours.
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Short-acting, such as Regular insulin, starts working within 30 minutes and lasts about 5 to 8 hours.
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Intermediate-acting, such as NPH or Lente insulin, starts working in 1 to 3 hours and lasts 16 to 24 hours.
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Long-acting, such as Ultralente insulin, doesn’t start to work for 4 to 6 hours, but lasts 24 to 28 hours.
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NPH and Regular insulin mixture, two types of insulin mixed together in 1 bottle, starts working in 30 minutes and lasts 16 to 24 hours.
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Where Do I Inject Insulin
Insulin is injected just under the skin. The easiest way to do this is to pinch up a fold of skin using your thumb and forefinger if you are injecting into your stomach or thigh area, or use your knee to create a pinched up area if you are injecting into your upper, outer arm. More detailed instructions are below. Your healthcare professional can also show you how to do it.
Insulin is injected into the less sensitive layer of fatty tissue just under the skin, so it should not hurt too much, but may sting or burn a little. You are not injecting insulin into a muscle or vein.
To keep your skin from thickening or getting lumpy, try not to inject in the exact same spot. Instead, rotate injection places.
Do not share needles, pens, or syringes with others. Do NOT reuse needles.
Are There Any Potential Side Effects
Side effects include low or high blood sugar levels , insulin resistance, and skin allergic reactions to the injections. High blood sugar levels may cause increased drinking, increased urination, or increased appetite.
Serious side effects due to low blood sugar levels include weakness, lack of energy, shaking, head tilting, sleepiness, incoordination, stumbling, seizures, blindness, abnormal behavior, restlessness, twitching, or coma.
Serious side effects indicating an allergic reaction may include hives, swelling of the head or neck, or difficulty breathing. If serious side effects are noted, this is an emergency, please see what to do in case of an emergency below and take your pet to the veterinarian immediately.
This short-acting medication should stop working within 24 hours.
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How Do I Inject The Insulin With A Syringe
- Wash your hands with soap and water. This will help prevent an infection. Dry your hands with a clean towel or paper towel.
- Clean the skin where you will inject the insulin. You can use an alcohol pad or a cotton swab dipped in alcohol.
- Grab a fold of your skin. Gently pinch the skin and fat between your thumb and first finger.
- Insert the needle straight into your skin. Do not hold the syringe at an angle. Make sure the needle is all the way into the skin. Let go of the pinched tissue.
- Push down on the plunger to inject the insulin. Press on the plunger until the insulin is gone. Keep the needle in place for 5 seconds after you inject the insulin.
- Pull out the needle. Press on your injection site for 5 to 10 seconds. Do not rub. This will keep insulin from leaking out.
- Throw away your used insulin syringe as directed. Do not recap the syringe before you throw it away.
What Should I Do In Case Of Emergency
If an overdose of insulin is suspected based on signs of low blood sugar levels, mildly low blood sugar levels can be treated by offering your pet some of his/her food. In more severe cases, rub Karo syrup, honey, or some other sugar syrup on the gums as long as your pet is not having an active seizure.
If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.
| Contributors: Rania Gollakner, BS, DVM, MPH |
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Example #: Formulas Commonly Used To Create Insulin Dose Recommendations
This example illustrates a method for calculating of your background/basal and bolus doses and estimated daily insulin dose when you need full insulin replacement. Bear in mind, this may be too much insulin if you are newly diagnosed or still making a lot of insulin on your own. And it may be too little if you are very resistant to the action of insulin. Talk to your provider about the best insulin dose for you as this is a general formula and may not meet your individual needs.
The initial calculation of the basal/background and bolus doses requires estimating your total daily insulin dose:
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Prepare The Insulin And Syringe
- Remove the plastic cap from the insulin bottle.
- Roll the bottle of insulin between your hands two to three times to mix the insulin. Do not shake the bottle, as air bubbles can form and affect the amount of insulin withdrawn.
- Wipe off the rubber part on the top of the insulin bottle with an alcohol pad or cotton ball dampened with alcohol.
- Set the insulin bottle nearby on a flat surface.
- Remove the cap from the needle.
If you’ve been prescribed two types of insulin to be taken at once , skip to the instructions in the next section.
- Draw the required number of units of air into the syringe by pulling the plunger back. You need to draw the same amount of air into the syringe as insulin you need to inject. Always measure from the top of the plunger.
- Insert the needle into the rubber stopper of the insulin bottle. Push the plunger down to inject air into the bottle . Leave the needle in the bottle.
- Turn the bottle and syringe upside-down. Be sure the insulin covers the needle.
- Pull back on the plunger to the required number of units .
- Check the syringe for air bubbles. Air bubbles in the syringe will not harm you if they are injected, but they can reduce the amount of insulin in the syringe. To remove air bubbles, tap the syringe so the air bubbles rise to the top and push up on the plunger to remove the air bubbles. Recheck the dose and add more insulin to the syringe if necessary.
- Remove the needle from the insulin bottle. Carefully replace the cap on the needle.
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The Importance Of Insulin
Insulin is a hormone that your body uses to help convert glucose from the food or drinks you consume into energy. Once insulin helps glucose enter your cells, blood sugar levels in your bloodstream decrease. Using insulin is critical for both those who do not make any insulin and for people who are unable to produce enough insulin to keep blood sugar levels in control.
People with type 1 diabetes need to inject insulin daily to survive, and sometimes people with type 2 diabetes need to add insulin shots to their therapy regimen in order to keep blood sugar levels in check. Women with gestational diabetes sometimes need to inject insulin as their pregnancy progresses and overall hormone levels rise, but insulin injections can often be discontinued after delivery.
About Insulin Pen Needles
Use a new insulin pen needle each time you give yourself an injection. Insulin pen needles have 4 main parts .
- A protective tab. This helps keep the needle clean. Youll need to remove this before attaching the needle to the insulin pen.
- An outer needle cap. This covers the needle before and after its used.
- An inner needle cap. This helps keep the needle clean before its used.
- A needle. This is how the injection is given into the skin.
Figure 2. Parts of an insulin pen needle
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How Do I Store Insulin
Store unopened insulin in the refrigerator between 2°C and 8°C . Protect from temperature extremes such as freezing or higher temperatures greater than 30°C or 86°F. Protect from direct sunlight. Some brands of opened insulin may be stored at room temperature and other brands require refrigeration, so refer to the label on your specific bottle of insulin for exact recommendations.
How To Give Insulin In The Arm With An Insulin Pen Or Syringe
Injecting insulin into the upper arm can be a bit tricky to do yourself but by using your knee you can create a pinched-up area of skin to inject into. If you find this difficult, for example, if you dont have much loose skin on your arms, it may be best to choose a different injection site, such as your stomach or thigh, or ask somebody else to hold up an area of pinched skin and give your injection for you. The same method can be used whether you are using a syringe or an insulin pen.
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How Do I Know How Much Insulin To Give
How much insulin a person needs depends on their blood sugar testing results, their blood sugar goal number, and their needs. Your doctor or nurse will work out your insulin dose for you, and then tell you how to change the dose if you need to, for example, if you exercise more one day, eat less, or are sick.
What If I Miss Giving My Pet The Medication
If you miss a dose, contact your veterinarian for advice on when to give the next dose. If you cannot reach your veterinarian and your pet is acting normally and is eating, skip the missed dose and give the usual dose at the next soonest regularly scheduled time. Never give your pet two doses at once or give extra doses.
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Diagnosing Diabetes In Cats
After a physical exam and discussion of your cats symptoms, your veterinarian will take blood and urine samples for testing.
In addition to checking the glucose levels in your cats blood and urine, your vet will be checking for evidence of other diseases that have symptoms similar to diabetes, like kidney disease and hyperthyroidism.
They will also check for conditions that can complicate the treatment of diabetes, like infections and diabetic ketoacidosis, which require hospitalization.
How To Give An Insulin Injection
Supplemental insulin, a man-made version of a hormone produced by the pancreas to control blood glucose, is vital for all people who have type 1 diabetes. It also may be a necessary part of treatment for those with type 2 diabetes when first-line measuresdiet, exercise, and/or medicationaren’t enough to control blood glucose.
Insulin cannot be taken as a pill or tablet because digestive enzymes would break it down before it could get into the bloodstream. Therefore, it must be injecteda prospect that may sound scary but, in fact, is routine for six million people in the United States, according to research published in 2016 in Diabetes Spectrum.
Whether you are new to self-injecting insulin with a syringe and needle, would like to fine-tune your technique or explore using an insulin pump or other alternative, or will be giving insulin shots to someone else regularly, there’s much to know about how best to administer this medication safely and effectively.
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Does Hypoglycemia Occur In Dogs
Hypoglycemia means low blood sugar. If the blood sugar falls below 40 mg/dl, it can be life threatening. Hypoglycemia generally occurs under two conditions:
“It is possible for the dog’s insulin requirements to suddenly change.”
Your veterinarian may have you offer an extra meal and recheck the glucose level within a short time after the dog eats.