Insulin is a lifesaving medicine for people with diabetes. But there is no such thing as an insulin pill—it can only be taken as a shot. However, today's syringes and insulin pens are much easier to use and much less painful than those in the past. Many people say that they feel almost no pain at all when they take an insulin shot.

There are two ways to give yourself insulin: from vials or with pens. If you are using a vial, you will also need syringes. If you are using a pen, you will also need pen needles. Both the syringes and the pen needles can be thrown away after you use them. It is common to take more than one type of insulin. Mealtime insulin is taken before meals to help manage food-related rises in blood glucose (sugar). Long-acting insulin helps to manage blood glucose throughout the day and needs to be taken at the same time every day. Your health care provider will tell you when to take your insulin and how much to take.

Your diabetes educator or other health care provider will have taught you how to take your shots. Here's a review:

  • Choose your site. Insulin can be injected into the upper arms or upper thighs, the abdomen either above or below your waist, or the buttocks. Avoid scars, moles, and the area around the belly button. Use the same area, but change the spot where you give your shot each time to protect your skin over time and ensure that the insulin is absorbed.

  • Prepare the insulin. Some insulins need to be mixed before you give a shot. Your provider will tell you if you are using this kind.

  • If you use a syringe: Fill the syringe. First, draw air into the syringe equal to the amount of your insulin dose. Push that air into the vial. Then draw up the insulin into the syringe. Check for air bubbles. Tapping the syringe should break up the bubbles so you will get your full dose.

  • If you use an insulin pen: Dial up your dose. Screw or snap the needle onto the end of the pen. Then turn the dial to the number of your dose. Before drawing up your dose you need to push out a unit or two to make sure that the pen is working. This is called an “air shot.”

  • Insulin shots should go into a fatty layer of your skin (called “subcutaneous” or “SC” tissue). Put the needle straight in at a 90-degree angle. You do not have to pinch up the skin unless you are using a longer needle (6.8 to 12.7 mm). Small children or very thin adults may need to inject at a 45-degree angle.

  • Wait 5 seconds before pulling out the needle. Counting to 10 is a good way to be sure that all of the insulin has gone in.

  • Dispose of the syringe or pen needle (see below). Using needles more than once is not recommended because the needle gets dull with each use and will be more painful.

TREATING HYPOGLYCEMIA (LOW BLOOD GLUCOSE)

Insulin can make you more likely to have low blood glucose, which can be dangerous if untreated. If your blood glucose goes low (usually under 70 mg/dl), a good rule of thumb is to take 15 grams of fast-acting carbohydrate, wait 15 minutes, check your glucose again, and repeat if necessary. You can buy glucose tabs or gels for this purpose, but there are also about 15 grams of fast-acting carbohydrate in:

  • 4 ounces of juice or soda (regular, not diet)

  • 8 ounces of skim milk

  • 5–6 Life Savers candies

Store vials or pens in the refrigerator until they have been opened. If the insulin freezes, you will have to throw it away. Once you start using a vial or pen, it can be kept at room temperature (less than 86 degrees) and out of direct sunlight. Insulin is less painful if you take it at room temperature. Depending on the type of insulin, it may be good for 14 to 40 days after opening. Check the package insert or ask your pharmacist or provider. Do not use clear insulin that has become cloudy or any insulin that has become clumpy. Check with your town or county about how to safely dispose of your used needles. Many places allow you to put used needles in a puncture-proof container like an empty laundry detergent bottle. Tape the top of the container closed and put it in the trash—not the recycle bin.

If you have trouble seeing the marks on a syringe or drawing insulin into a syringe, ask your diabetes educator or pharmacist about devices that can make taking insulin easier.

Permission is granted to reproduce this material for nonprofit education purposes. Written permission is required for all other purposes. Please send requests to permissions@diabetes.org, referencing Clinical Diabetes, Vol. 31, issue 1.