Chapter Six: Insulin Injections :: Nationwide Children's Hospital

Insulin Injections

How do I prepare an insulin pen?

  1. Calculate your insulin dose (see chapter seven).
  2. Wash your hands.
  3. Read the label on the insulin pen to make sure you have the right pen.
  4. Take the cap off of the pen. Use alcohol to clean the rubber seal on the end of the pen.
  5. Remove paper tab from the pen needle.
  6. Push the capped needle onto the pen. Tighten needle by screwing clockwise.
  7. Pull off the outer needle shield. Save this shield. Pull off the inner needle shield and throw it away.
  8. Dial 2 units by turning the dose knob to “2.”
  9. Point the pen needle upwards. Tap the pen so air moves to the top of pen.
  10. With the needle pointing up, push the dose button until it stops. A stream of insulin should appear. If it does not, repeat steps 7 to 9. This is called priming the pen. This gets air out of the needle.
  11. Dial the dose knob to the right number of insulin units that you need. You are now ready to give the injection.
  12. After giving the injection, put the outer shield back on the needle. Unscrew the used needle, and throw it away.

How do I prepare an insulin injection by syringe?

  1. Calculate your insulin dose (see chapter seven).
  2. Wash your hands.
  3. Read the label on the insulin bottle (vial) to make sure you have the right type of insulin.
  4. Clean the top of the insulin vial with alcohol.
  5. Take the white cap off of the bottom of the syringe.
  6. Take the orange cap off of the needle top.
  7. Pull air into the syringe equal to the amount of insulin that you need to take (Picture 1).
  8. Push the needle through the rubber stopper of the vial (Picture 2). Inject the air into the vial.
  9. With the needle still in the vial, turn the vial and syringe upside down. Be sure the tip of the needle is in the insulin. Draw up the amount of insulin you need to inject (Picture 3).
  10. Check the syringe for air bubbles. If bubbles are in the syringe, push the insulin back into the bottle of insulin. Draw up the needed amount of insulin again to inject.
  11. Take the needle out of the bottle. You are now ready to give the injection.

Where do I give an insulin injection?

Inject the insulin in the fat layer just under the skin. This is known as a subcutaneous injection. There are four different areas you could use. These areas are the legs, arms, stomach, and hips.

To find the right injection site:



Measure one hand-width down from the hip and one hand -width up from the knee. Use the outer part of the leg. Try not to use the muscular top of the legs.
Measure one hand-width down from the shoulder and one hand-width up from the elbow. Use the fleshy, outer part on the back of the arm.



Use the area on either side of the belly button (navel). Start one inch (2 fingerwidths) away from the navel and move sideways to the hips.
Draw an imaginary line down the center of the buttock. Use the upper outer area of the hip.

How do I keep from getting scar tissue?

Use different areas of your body and different places (sites) within each area. If one site is used too much you may get scar tissue. This may look like swelling or a hard lump. It is hard to inject insulin into scar tissue. If you use the area with scar tissue, insulin may leak out. Even if it does not leak, you may see higher blood glucose levels at your next blood glucose check. This is because your body is not getting enough insulin. If you have scar tissue, do not use that site for at least 3 months. When you start using that site again, look at the next blood glucose after using that site. If that blood glucose is higher than expected, there may still be scar tissue.

How do I give an insulin injection?

  1. Pick the injection site.
  2. Clean the area with alcohol or soap and water. If you use alcohol, allow the skin to dry to prevent stinging.
  3. Insert the needle straight into the skin. Push the plunger on the syringe or the button on the insulin pen until all insulin is injected.
  4. Count slowly to 10.
  5. Remove the needle from the skin.
  6. Check the site to see if insulin leaks out. If this happens, make a note in your logbook. Your next blood glucose may be higher than expected.

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