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Insulin injections

The proper injection of insulin is very important to allow your body, which lacks natural insulin, to function as normally as possible. You should be very strict about the way you manage your insulin injections and have your technique down to a fine art.

Common mistakes

• poor mixing techniques when mixing insulin
• wrong doses (because of poor eyesight)
• poor injection technique-into the skin or
• muscle rather than the soft, fatty layer
• not taking insulin when you feel ill

When to inject insulin

Develop a set routine including eating your meals on time and giving the injections about 30 minutes before your meal.

Where to inject insulin

The injection should go into the fatty (subcutaneous) tissue between the skin and muscle. The best place is the abdomen below the navel. Other suitable areas are the buttocks and thighs. These areas have a good layer of fat under the skin and are free of large blood vessels and nerves. It is advisable to stick to one area, and the abdomen is recommended. Avoid giving injections into your arms, near joints, the navel and the groin.

Do not inject too often into the same small area (it can damage the tissue). Give the injection at a different place each time. Keep a distance of about 3 cm (1¼ inches) from the last injection.

How to inject insulin

• Lift up or pinch a large area of skin on your abdomen between your thumb and fingers.
• Hold the syringe in your other (dominant) hand between your thumb and middle finger: this leaves the index finger free to push the plunger.
• Insert the needle straight in (like a dart) at right angles to the skin (push the needle well in but not into muscle).
• Push the plunger all the way down.
• Quickly withdraw the needle.
• Press down firmly (do not rub or massage) over the injection site for up to 60 seconds.

Drawing up the insulin

• Make sure your technique is checked by an expert.
• You may be using either a single insulin or a mixed insulin. A mixed insulin is a combination of shorter and longer acting insulin and is cloudy.

Rules for mixing

• Always draw up clear insulin first.
• Do not permit any of the cloudy insulin to get into the clear insulin bottle.
• Do not push any of the clear insulin into the cloudy insulin bottle.

Drawing up rules

• Wash and dry your hands beforehand.
• Gently roll the insulin bottle between your hands to mix-do not shake it.
• Always draw up air equal to the dose of insulin into the syringe.
• Always expel air bubbles and ensure you do not inject air.

Storing insulin

• Keep insulin stores (unopened bottles) in the refrigerator, not the freezer.
• Opened bottles can be stored in a cool, dark place; refrigeration is not necessary.
• Keep insulin out of heat and sunlight.
• Keep an eye on expiry dates on the bottles.

Golden rules

1. Take your insulin every day, even if you feel ill.
2. Do not change your dose unless instructed.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia