How to Inject Insulin

Everyone who needs insulin is shown how to inject it during their first visit to the diabetes clinic. Plenty of time is allowed to discuss all the available options and to choose a delivery method with which the person feels comfortable and confident. Time is also allocated for demonstration and practice of the technique. Fear of needles is a problem that is well recognized by clinical care staff and not something which is treated lightly or laughed at but regarded as a difficulty that must be worked through and overcome. This is always achievable. A minority of people have a true needle phobia and this may take a little more time to deal with. A probable approach would be to suggest that the person undertakes a programme of behavioural therapy, which is normally successful in overcoming phobias. It is never the case that someone is forced into accepting insulin treatment without the necessary help to make this possible, or left to get on with it on his or her own. Full support is given from the start and continues to be available.

Although the idea of self-administered injections may seem daunting at first, for most people this rapidly becomes a matter of routine which is dealt with as easily as, for example, brushing one's teeth. An easily available site, such as the thigh or abdomen, will probably be suggested for the first injection and advice will be given on how often to change the site in order to avoid soreness or possible slight tissue damage. Hands should be washed prior to giving the injection and the person is usually advised to take a good pinch of skin and insert the needle at an angle of 90 degrees to its full depth. The plunger is then gently and firmly depressed to expel all the insulin. After five seconds, the needle is then carefully withdrawn.

Insulin Delivery Devices

Insulin given to treat diabetes has to be delivered by means of a subcutaneous injection, that is, one beneath the skin, and the most usual sites are the thighs, upper arms, abdomen or buttocks. There are three main ways in which insulin is given.

• Conventional method by means of a needle and syringe. Insulin is drawn up into the syringe by inserting the needle into the vial or bottle through a stopper. Vials may contain a single type of insulin or mixtures. Disposable plastic syringes, especially for insulin, are available in various sizes.
• A pen device and cartridge which contains the insulin. Cartridges may contain 1.5 ml or 3 ml of insulin and are changed when empty. Disposable needles are used with pen devices.
• A pre-loaded pen with integral needle, all of which is disposed of once empty.

There are various pen devices available, some of which are designed to be used with particular ranges of insulin and each may have slightly different operating instructions.

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