Drawing and Injecting Insulin

The following information explains how to draw insulin, how to rotate insulin injection sites, and how to properly dispose of sharps.

Insulin drawing techniques

Remember: you can always practice with saline!

  1. Collect all your supplies:
    • Insulin
      • Tip: If you store your insulin vials in the refrigerator, you can warm up the insulin by holding the filled syringe in the palm of your hand for one to two minutes. This will take the sting out!
    • Syringe
    • Alcohol wipe for tops of bottles
    • Your log book to record your blood glucose and insulin dosage
  2. Know the correct insulin dosage before starting.
  3. Disinfect! Swab the top of the insulin bottle with alcohol.
  4. Mix cloudy (intermediate-acting) insulin vial by gently turning the bottle up and down 20 times to make sure the insulin gets well mixed. There should be no clumps of insulin in the bottle.
  5. Draw up the air for the cloudy insulin and inject into the cloudy bottle.
  6. Draw up the air for the clear insulin and inject into the clear bottle.
  7. Draw up the clear (short-acting) insulin, get rid of air bubbles and remove the needle.
  8. Slowly add the cloudy insulin into the syringe, making extra careful not to push the insulin back into the vial.
  9. Your insulin is now ready.

Injection site rotation

Rotating your injection sites is very important. When insulin is injected into the same spot repeatedly, scar tissue may develop, and insulin will not be absorbed appropriately. This means that the insulin may not work as it should. Your blood sugars can then fluctuate unexpectedly.

Individual injection spots should be kept about an inch apart. The absorption rate of insulin varies from site to site. Tummy injections absorb the quickest, then arms, legs, and buttocks. One recommendation is to use all the spots in one site and then move onto another site. Other sources recommend using the same site at the same time of day (for example, breakfast: arms, lunchtime: belly, suppertime: legs, and bedtime: buttocks).

Exercising the limb you just used for an injection can affect the speed at which the insulin is absorbed, and thus may lower your blood sugars more quickly than expected. When planning for exercise, you should avoid injecting insulin into the exercising limb. The insulin may be absorbed too quickly and cause your blood glucose to dive.

Some examples of where to inject when exercising:

  • Baseball/softball: Tummy
  • Basketball: Tummy
  • Football: Tummy
  • Golf: Leg
  • Lacrosse: Tummy
  • Rugby: Tummy
  • Running: Arm
  • Skiing: Tummy
  • Soccer: Arm
  • Tennis: Tummy
  • Volleyball: Tummy

Disposal of sharps

All used pen needles, syringes and lancets ("sharps") need to be disposed of properly. They should not be thrown into the regular trash but placed in a puncture-proof container such as:

  • A heavy plastic laundry detergent bottle
  • A coffee can
  • An actual sharps container purchased at a pharmacy

When the container is 3/4 full, it should be sealed before disposal.

If you take your trash to a central collection area, you should check with them first about disposal. Sharps containers can also be turned in at the central information desk at Dartmouth Hitchcock Medical Center.

If you have any questions, please contact your health care provider.