Diabetes: Giving Yourself an Insulin Shot
Introduction
If you have
type 1 diabetes—or if you have
type 2 diabetes and medicines are not
controlling your blood sugar—you have to take
insulin. If you have
gestational diabetes,
you may need to take insulin if diet and exercise have not been able to keep
your blood sugar levels within your target range.
With little or
no insulin, sugar (glucose) in the blood cannot enter your cells to be used for
energy. As a result, the sugar in your blood rises above a safe level. When
your blood sugar rises past about 180 mg/dL, your kidneys begin to release
sugar into the urine, which can make you
dehydrated. If you are dehydrated, your kidneys make
less urine, which means your body can't get rid of extra sugar. This is when
blood sugar levels rise. If you can drink enough fluid to prevent getting
dehydrated, you'll be able to release excess sugar in your urine.
Taking insulin can prevent the symptoms of high blood sugar and emergencies
such as
diabetic ketoacidosis (in type 1 diabetes) and
hyperosmolar coma (in type 2 diabetes). Insulin also
can help prevent serious and permanent complications from long-term high blood
sugar.
Most people use insulin in an injection, or shot. It is
given into the fatty tissue just under the skin. It also can be given through
an
insulin pump, an
insulin pen, or a device that sprays the medicine
into the skin (jet injector). And now skin patches are available with insulin in them, which can be worn for days. Experts are studying other ways of giving
insulin, such as in an implantable pump. But this information is
about insulin in syringes.
After you get past the initial anxiety,
giving yourself a shot will become a routine part of your day. It's quite easy
to learn the basics of drawing the insulin up into a syringe and injecting it.
Although never pleasant, the sting of the injection is not bad and does not
last long. More than 500,000 people do it every day. You can, too.
The three most important elements of success in giving insulin injections
are:
- Making sure you have the right dose of insulin,
especially if you are giving two types of insulin in the same
syringe.
- Practicing how to give your injection.
- Storing
the insulin properly so that each dose will work effectively.
Insulin for injection comes in small glass bottles
(vials) and cartridges. Both are sealed with a rubber lid. One bottle or
cartridge contains many doses. To remove a dose of insulin from:
-
A bottle, you will use an
insulin syringe. You will also use the syringe to inject the insulin.
-
A cartridge, you will use a pen-shaped device
called an
insulin pen. The cartridge fits inside the pen and the
dose of insulin is set with a dial on the outside of the pen. The pen (with the
cartridge inside) is used to give the medicine. Both disposable and reusable
insulin pens are available. Each pen operates slightly differently.
Some insulin pens work with premixed insulin cartridges, such as Humulin 70/30, NovoLog Mix 70/30, and Humalog Mix 50/50.
To give an insulin injection, you insert the needle
(attached to the syringe) into your skin. Push the plunger to inject the
medicine into the fatty tissue just below the skin. Insulin usually is injected
into the abdomen, upper arm, or thigh.
Your doctor may have you
take two types of insulin at the same time. Because most types of insulin
prescribed to be taken at the same time can be mixed together, you most likely
will be able to give both doses in the same syringe. But you cannot mix the
long-acting insulin glargine (Lantus) or insulin detemir (Levemir) in the same syringe with other types of
insulin.
Test Your Knowledge
To withdraw a single dose of insulin from a bottle, I
need to use a syringe.
-
True
This answer is correct.
To withdraw a single dose of insulin from a
bottle, you do need to use a syringe.
-
False
This answer is incorrect.
To withdraw a single dose of insulin from a
bottle, you do need to use a syringe.
-
To give an injection of insulin, the needle of the
syringe is inserted into the skin and the medicine is pushed into the fatty
tissue just under the skin.
-
True
This answer is correct.
To give an injection of insulin, the needle of
the syringe is inserted into the skin and the medicine is pushed into the
fatty tissue just under the skin.
-
False
This answer is incorrect.
To give an injection of insulin, the needle of
the syringe is inserted into the skin and the medicine
is pushed into the fatty tissue just under the skin.
-
Continue to Why?
Normally, insulin is produced by
the pancreas. Insulin lets sugar (glucose) in the blood enter body cells, where
it is used for energy. It helps the body store extra sugar in muscles, fat, and
liver cells. Later, that sugar can be released if it is needed. Without
insulin, the body cells cannot use sugar, causing the blood sugar level to rise
above what is safe for your body.
You need to take insulin because
you have:
- Type 1 diabetes, which causes your body
to produce little or no insulin. You have to take one or more types of insulin
for the rest of your life.
- Type 2 diabetes, which causes your body to require more insulin than it can
produce. When your body starts producing too little or no insulin, you will
have to take insulin for the rest of your life. You may need to take insulin
for a short time if your body is under unusual stress, such as if you are
having major surgery, are severely ill, or become pregnant.
- Gestational diabetes. Your body is not able to use
insulin properly. You will need to take insulin during your pregnancy if
getting regular exercise and eating a balanced diet does not keep your blood
sugar levels within your target range.
Test Your Knowledge
A person whose pancreas produces little or no insulin
has to take insulin.
-
True
This answer is correct.
A person whose pancreas does not produce any or
enough insulin has to take insulin. This includes people with type 1 diabetes,
some people with type 2 diabetes, and some women with gestational
diabetes.
-
False
This answer is incorrect.
A person whose pancreas does not produce any or
enough insulin has to take insulin. This includes people
with type 1 diabetes, some people with type 2 diabetes, and some women with
gestational diabetes.
-
People with type 2 diabetes who are under unusual
stress, such as having major surgery, may need to take insulin for a short
period of time.
-
True
This answer is correct.
People with type 2 diabetes who are under
unusual stress, such as having major surgery, may need to take insulin for a
short period of time.
-
False
This answer is incorrect.
People with type 2 diabetes who are under
unusual stress, such as having major surgery, may need to take insulin for a
short period of time.
-
Continue to How?
Your
health professional or certified diabetes educator (CDE) will help you learn to prepare and give your insulin dose.
Here are some simple steps to help you learn this task.
Get ready
To get ready to give an insulin
injection, follow these steps.
- Wash your hands with
soap and running water. Dry them thoroughly.
- Gather your supplies. You will need an
insulin syringe, your bottle (or bottles) of insulin, and an alcohol wipe or a
cotton ball dipped in alcohol. Most people keep their supplies in a bag or kit
so they can carry the supplies wherever they go.
- Check the
insulin bottle label and contents. When you use an
insulin bottle for the first time, write the date on the bottle. On the 30th
day after opening, throw away the bottle with any remaining insulin. Insulin
may not work as well after 30 days of use.
Prepare the injection
Your preparation will depend
on whether you are giving one type of insulin or mixing two types of
insulin.
When you are mixing types of insulin to be given in one syringe, follow these precautions.
- If you are mixing NPH and short-acting regular insulin, you can use it right away or put it aside to be used
later. Keep it away from heat and light, such as in a refrigerator.
- Insulin glargine (Lantus) and insulin detemir (Levemir) cannot be mixed with other types of insulin. They also
cannot be given in a syringe that has been used to give another type of insulin.
If you have poor eyesight, have problems using your
hands, or cannot prepare a dose of insulin, you may need someone to prepare
your insulin injections ahead of time.
Prepare the site
Before giving your
injection:
- Choose the part of your body to inject. If you give your injections in different places on your body each
day (rotate sites), use the same site at the same time of the day. For example,
each day:
- Clean the site. If you use alcohol to clean the
skin before you give the injection, let it dry.
Give the injection
Follow these steps for giving
an insulin injection.
- Slightly pinch a fold of skin between your
fingers and thumb of one hand. But if you are using a shorter insulin needle, pinching the skin is not needed. Shorter needles make it easier to inject insulin into areas with less fat, such as the upper arm.
- Hold the syringe like a pencil close
to the site, keeping your fingers off the plunger. Usually the syringe is at a
90-degree angle to the skin site. If you are a thin adult, you may want to
insert the needle at a 45-degree angle or use a shorter needle.
- Bend your wrist and quickly
push the needle all the way into the pinched-up area. Then let go of the
pinched-up area.
- Push the plunger of the syringe all the way in so
the insulin goes into the fatty tissue. Wait a few seconds to make sure the
insulin gets into the tissues.
- Take the needle out at the same
angle that you inserted it. If you bleed a little, apply pressure over the
injection site with your finger, a cotton ball, or piece of gauze. Do not rub
the area.
- Replace the cover over the needle. Although syringe
manufacturers do not recommend it, some people reuse their syringes until the
needle becomes dull or bent. If you plan to reuse your syringe, see
precautions when reusing syringes.
Cleanup and storage
After giving your injection,
be sure to:
-
Store your insulin properly so that
each dose from the bottle will work effectively.
- Dispose of your
used syringe. Do not throw your used syringe and needle into a household
wastebasket or trash can. You can dispose of them in a metal container, such as
a coffee can, that has a lid that screws on or that you tape down tightly. You
also can buy special containers for disposing of used needles and syringes. You
can also buy a small needle clipper device that breaks the needle off the
syringe and stores it safely for disposal. Talk with your local trash disposal
agency, pharmacy, or your health professional about how to get rid of the
container.
Other tips for success and safety
- You can
practice injecting air or water into an orange until you feel comfortable with the
steps for giving insulin. Then do the steps in front of your doctor or certified diabetes educator and ask him or
her how you did.
- Teach other family members how to give insulin
injections. Have at least one other person who can prepare and give your insulin injection in an emergency. It's a good idea to let this person
give your scheduled insulin injection for practice. Then it will not be as
unfamiliar when an emergency occurs.
- Never share syringes with another person because of
the risk of getting diseases that can be transferred through blood, such as
acquired immunodeficiency syndrome (AIDS) or infection of the liver
(hepatitis).
Test Your Knowledge
The first step in preparing insulin from a bottle is
to roll the bottle gently between your hands.
-
True
This answer is correct.
The first step in preparing insulin from a
bottle is to roll the bottle gently between your hands. This will warm the
insulin if you have been keeping the bottle in the refrigerator. Roll a bottle
of cloudy insulin until the white powder has dissolved.
-
False
This answer is incorrect.
The first step in preparing insulin from a
bottle is to roll the bottle gently between your hands. This will warm the
insulin if you have been keeping the bottle in the refrigerator. Roll a bottle
of cloudy insulin until the white powder has dissolved.
-
When you are preparing a cloudy and a clear insulin to
give a mixed dose, which do you put into the syringe first?
-
Cloudy insulin
This answer is incorrect.
When you are preparing a cloudy and a clear
insulin to give a mixed dose, you put the clear insulin
into the syringe first.
-
Clear insulin
This answer is correct.
When you are preparing a cloudy and a clear
insulin to give a mixed dose, you put the clear insulin into the syringe first.
-
Continue to Where?
Now that you have read this
information, you are ready to start preparing and giving insulin
injections.
If you would like more information on preparing and giving
insulin injections, the following resources are available:
Organization
|
American Diabetes Association (ADA)
|
| 1701 North Beauregard Street |
| Alexandria, VA 22311 |
| Phone: |
1-800-DIABETES (1-800-342-2383) |
| Email: |
AskADA@diabetes.org |
| Web Address: |
www.diabetes.org |
| |
|
The American Diabetes Association (ADA) is a national organization
for health professionals and consumers. Almost every state has a local office.
ADA sets the standards for the care of people with diabetes. Its focus is on
research for the prevention and treatment of all types of diabetes. ADA
provides patient and professional education mainly through its publications,
which include the monthly magazine Diabetes Forecast,
books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also
provides information for parents about caring for a child with diabetes.
|
|
More information about diabetes can be found in these
topics:
Return to topic:
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
E. Gregory Thompson, MD - Internal Medicine |
|
Specialist Medical Reviewer
|
Rhonda O'Brien, MS, RD, CDE - Certified Diabetes Educator |
|
Last Revised
|
July 19, 2011 |
Last Revised:
July 19, 2011