When you need insulin to manage your diabetes, that often means learning how and when to give yourself injections. The good news is that it’s easier and less painful than ever before.
Kathy Bostrom, 68, has been handling injections herself for more than 15 years. She says the shot quickly becomes no big deal once you get the hang of it.
“Syringes have come a long way since I started my journey,” says Bostrom, who lives in Mills River, N.C. The bigger challenge for her is “the testing, remembering to record it, and eating the right foods.”
Injectors come in two kinds: syringes and pens. You and your doctor can pick which one is better for you.
Syringes are simple and have been around the longest. But they’re also more prone to making errors, says Ellen Leschek, MD, program director of the division of diabetes, endocrinology, and metabolic diseases at the National Institute of Diabetes and Digestive and Kidney Diseases.
“You have to rely on a person looking at the needle, drawing up to the correct number of units, making the correct judgment that they’ve got the right number of units in there, and not making a mistake in any of those steps,” Leschek says.
Injectable pens, on the other hand, are preloaded with insulin. You screw or snap on a needle to the end and dial the pen up to the dose you need. “It’s a little more user-friendly and fail proof,” Leschek says.
You’ll also need a few other supplies, including:
- A glucometer kit to test your blood sugar levels
- Alcohol wipes for vial tops and your skin at the injection site
- A sharps container for used needles
You’ll also want have all these things in a travel pack you can take with you on the go. As a last resort, you can dispose of your used needles in a plastic bottle with a cap.
Your doctor will tell you how many times a day you need to take your insulin. You may need to do it only once, or up to four times daily.
Insulin comes in several forms:
Rapid-acting. It starts to work about 15 minutes after injection.
Regular, or short-acting. Also called a mealtime insulin, you take it about 30 minutes before you eat to control your blood sugar after a meal.
Intermediate-acting. It takes about 2-4 hours to reach your bloodstream and works for about 12-18 hours.
Long-acting. You take it the same time every day.
Ultra long-acting. Some of these can work for 36 hours or longer, so you need fewer injections.
You may also need to take two different kinds of insulin together.
Tom Cullen, 46, of New Orleans, says it took time for him to get comfortable with self-injections. “I was nervous, especially the first couple of times,” he says.
Now, “it’s like putting in contacts or tying a tie. It’s just a regular part of my daily routine.”
To give yourself an injection, you:
- Wash your hands.
- Wipe off the top of the vial (if you’re using one) with an alcohol swab.
- For a syringe: Draw air into the syringe that’s equal to your insulin dose amount. Push the air into your vial of insulin. Draw the insulin into the syringe. Then tap the syringe to make sure all the air bubbles are gone.
- For a pen: Attach the needle to the end. Push out a unit or two (an “air shot”) to make sure the pen is working. Dial up your dose.
- Hold the needle at a 90-degree angle to your skin and push it into the fatty outer layer. Then push the insulin pen button or press the plunger of the syringe.
- Put the needle in a sharps container.
You can pinch your skin where you give yourself the shot. But Leschek says you don’t have to because the needle is so short.
“If you do pinch yourself, make sure you let go after the needle is in, count to 10, and then take it out.” Keeping the pinch too long can squeeze some of the insulin back out, and you won’t get your full dose.
Here are some tips to follow about insulin injections:
Keep it cool. Insulin can be kept at room temperature for a while. But it’s best stored in the refrigerator. If you think you’ll be out of the house for a while, take your insulin in an insulated lunch box to keep it from getting too warm.
Rotate injection sites. If you inject in the same place, your skin will thicken and harden into fatty lumps. Insulin won’t absorb in these spots as well. So use a different site each time. Leschek recommends a grid system. Draw a grid of your arms, legs, abdomen, and buttocks on paper and keep track of where and when you inject yourself. You can start with your left arm, right arm, left leg, right leg, right side of the belly, then left, then right and left buttock. Repeat.
Watch your numbers. Your blood sugar levels, and how you feel, are the best ways to know if your injections are working. If you numbers are hard to control or if you see high and low blood sugar levels, Leschek says you should double-check your technique. A certified diabetes educator can watch you inject your insulin and make sure everything’s going smoothly.
Think ahead. Mealtime injections mean planning out what you’re going to eat so you get the right dose. Have a travel pack of supplies and snacks like peanut butter or hard candy ready in case you head out somewhere where there’s no food.
Tag in your team. Good diabetes care takes a team. In addition to your endocrinologist, you should also work with a certified diabetes educator or pharmacist who can answer your injection questions.
Be open and honest. In order to help you feel your best, your team needs to know exactly how your injections are going. “Tell the truth — they’ve heard it all before,” Bostrom says. “And then don’t beat yourself up about it. It’s a learning curve every day. You’ve got this.”