Dr Aidin Rawshani

How to handle and inject insulin (injection technique)


How to deal with and inject insulin

To get insulin, syringes are used. There are many different types of syringes and the modern syringes are easy to handle and dose. When injecting insulin, the needle itself should be inserted through the skin so that it can be injected into the fat under the skin. It is important not to inject insulin into a muscle, as the insulin gets too fast into the bloodstream, which can lead to a fall in blood sugar (hypoglycaemia). If you experience unexpected blood sugar drops while injecting insulin, consider the following:

  • The dose may be too high.
  • You may have eaten too little before injecting insulin.
  • You may inject into a muscle.

If you suspect that you are injecting into muscle, consider changing the injection site or requesting shorter needles. If you have problems with your injections, or have a recurrent drop in blood pressure after injection of insulin, you must talk to your healthcare provider. See details below.

How to deal with insulin

Insulin used (injected) should be at room temperature and should also be stored at room temperature. The insulin not being used should be stored in a refrigerator. Do not freeze or cool insulin as this affects the activity of insulin. Avoid having your insulin in direct sunlight as it also reduces insulin effectiveness. Temperature above 25°C also means that the insulin gradually loses its effect.

Mixinsulin (Humalog Mix or Novomix), medium-acting NPH type insulin (Insulatard, Humulin NPH and Insuman Basal) should be shaken before use.

More about Insulin Insulin Injection

Insulin should be injected into the subcutaneous fat where it is absorbed into the bloodstream. If the insulin is injected into the skin, it takes longer for sufficient concentrations to be absorbed into the bloodstream because the skin has fewer blood vessels than the fat. If you inject too deep, for example into the abdominal muscles, you risk that insulin will be absorbed too quickly because there are more blood vessels in the muscles. Insulin can be injected at several sites, most commonly the injection site is the abdomen, the front or outside of the thighs, or the upper part of the buttocks.

The most common variant of insulin (Actrapid, Humulin, Insuman rapid, Insulatard, Humulun NPH, Insuman basal) is absorbed more quickly from the abdomen than from the thighs and buttocks. For direct acting insulins such as Humalog, Novorapid and Apidra, there is a difference in insulin uptake between injection sites.

When using insulin Lantus, Abasaglar and Toujeo, the absorption time and duration are similar in the abdomen, thigh and buttock.

Insulin sortInjection area
Meal insulinAbdominal area
BasinsulinThighs or buttocks
Lantus, Absaglar,
Toujeo, Levemir,
Firstly, in thighs but can also be given in the abdomen or upper arm.
Mixed insulinInsulin can be given in the abdomen by breakfast and thighs or buttocks in the evening.

How to inject insulin into the abdomen, thighs or buttocks

  • First inject a few units (E) to check that the needle is working and empty it of any air.
  • Grasp a skin fold with 2-3 fingers and hold for the entire injection.
  • Insert the needle straight into the skin and inject it. Wait about 5-10 seconds before the needle is pulled out.
  • Vary the injection site with a few centimeters from time to time to avoid lipohypertrophy (thickening of the adipose tissue).
  • Do not inject through clothes.
  • The thickness of needles varies and is guided by the thickness of the subcutaneous fat.

Lipohypertrophy (fat pads) often occurs if you inject at the same site regularly or if you try to inject insulin with blunt needles. Fat pads have few blood vessels and injecting insulin into them leads to slower uptake of insulin and swinging blood sugar. If you have been given fat pads, you should avoid sticking in them, after which they disappear after a few months.

Many people with diabetes are concerned about pain when injecting insulin. There are several methods that can help avoid or minimize pain when injected. Most often, it is the length of the cannula that is the underlying cause of the pain.

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