A prick in time

Even the thought of an injection makes all of us wince, so having to prick a needle in yourself may naturally seem frightening. That’s probably why switching from oral diabetes medications to insulin injections is something that most diabetics resist.

But insulin is a life-saving medicine and it is prescribed only when oral medications are no longer effective. Taking insulin injections is not difficult once you get used to it; your doctor or diabetes nurse or educator will initially help you to learn the injection technique. For very small children parents can learn how to administer insulin, but older children, adolescents and adults can learn to take their insulin injection themselves. This makes insulin therapy effective and successful.

Injection site

Since insulin needs to be taken daily 3 – 4 times a day it is best to alternate the insulin injection sites. You could take the insulin injection in the abdomen, thighs or back of the upper arm. Though, for taking injection in the upper arm you may require assistance.

Remember that insulin is absorbed most rapidly when injected on the abdomen, followed by the arm and most slowly from the thighs. Due to this difference in absorption rate from different sites use the same part of the body for each of your daily injections. For example, take all the morning doses in the abdomen, afternoon doses in the arm and evening injections in the thigh. To prevent formation of hard lumps below the skin it is good to alternate within injection sites. Keep each of your pricks at least two finger’s width from the last prick.

Right technique

Injecting at the proper depth is an important part of good injection technique. It has to be injected in the fatty layer beneath the skin but just above the muscle. If you inject too deep, the insulin could go into the muscle, where it’s absorbed faster and the effects will not last so long.

While if the injection is not deep enough, the insulin goes into the skin, and it takes longer for it to start acting. You could pinch up a fold of skin and insert the needle at an angle between 45° and 90° in the skin fold. If you use a 4 – 6mm mini pen needle to inject, you don’t have to pinch up the skin. Simply inject at a 90° angle.

• Before injecting wash your hands thoroughly and have your insulin, syringe or pen, cotton and alcohol ready.
• Roll the vial of insulin, especially if it is a milky one, about 10 – 15 times between your palms and clean the top of the vial with alcohol.
• Draw in air according to the number of insulin units.
• Push this air in the insulin vial and draw insulin into the syringe.
• If you have been recommended intermediate acting and short acting insulin, they can be mixed in the same syringe. The short acting insulin is always drawn into the syringe first.
• Make sure there is no air in the syringe before injecting.
• After injecting, wait for 10 seconds before you withdraw the needle.
• You can eat 30 minutes after injecting your insulin if you use human insulin and if you use modern insulin you can eat immediately.
• Insulin syringes must be matched with correct strength of insulin.
• Do not use alcohol to clean your needle as this removes the coating that helps the needle slide into the skin easily and makes injection painful.

Storage of insulin

Insulin that’s improperly stored or past its expiration date may not be effective. Ideally insulin should be stored at 2 – 8°C. Once opened, a vial of insulin should ideally be used within three months. If not refrigerated, a vial should be used within one month of opening. If a refrigerator is not available, for instance when you are travelling, then store the insulin in a cool place, like a properly sealed plastic bag kept in a bowl filled with water or a cloth bag dipped in water and hung in a ventilated and shady place.

Injecting cold insulin can sometimes make the injection more painful. To avoid this, you can keep your syringe and bottle of insulin at room temperature for 5 – 10 minutes before using.

Do not store your insulin near extreme heat or extreme cold. Never store insulin in the freezer or expose it to direct sunlight.

Reuse of syringe

Although all needles and syringes are recommended for single use, for the purpose of administering insulin you may want to reuse syringes as that could be more economical. However, discuss this with your doctor or nurse before you begin reusing. Do not reuse if you are ill, have wounds on your hands, or have poor resistance to infection. If you plan on reusing your syringe keep the needle capped at all times when you’re not using it. Never let the needle touch anything other than your disinfected skin and the top of the insulin bottle. Never let anyone use a syringe you’ve already used, and don’t use anyone else’s syringe.

This was first published in the September 2012 issue of Complete Wellbeing.