Giving the injection
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Gather together the insulin-loaded syringe and a dry cotton swab or tissue.
- Select the injection site. (illustration)
- Gently pinch up the skin and fat with the thumb and forefinger.
- Hold the syringe like a pencil, close to the needle for better control.
- Push the needle in quickly and all the way, at a 90-degree angle to the pinched-up skin.
- Push the plunger in to inject the insulin.
- Slowly let go of the pinched-up skin and then remove the needle.
- Using a dry swab, apply gentle pressure to the injection site to prevent bruising.
- Discard the needle and syringe in a special container, available at your pharmacy, or recycle a juice can or empty bleach container. To avoid possible injury, never leave used needles lying around.
Selecting the injection site
There are 4 safe areas for insulin injections.
- Thighs: Top and outer areas only. Do not use the inner side or back of the thigh. Stay about 4 of the child’s finger widths away from the knee and groin.
- Upper arms: Fleshy area on the side and back of the arms. Avoid the muscle in the shoulder. Stay 3 to 4 finger widths away from the elbow.
- Abdomen: Right across the abdomen, from just below the ribcage to well below the belt line. Stay about 2 finger widths away from the navel.
- Buttocks: Fleshy area (i.e. pants pocket area).
Insulin may be absorbed differently from one site than another. Absorption is most predictable when injections are given in the abdomen and buttocks. In general, insulin injected into the upper arms or thighs is not absorbed as predictably. Also, insulin injected over an exercising muscle may be absorbed more quickly. For that reason, it’s wise to avoid injecting into the arms or thighs of someone who’s planning heavy exercise involving these muscles. In other words, runners should avoid injecting into the thighs, rowers should avoid injecting into the arms, and so on.
Injections are done in a pattern to avoid using exactly the same site over and over. Make sure that each injection is about 1 inch (2.5 cm) or 2 finger widths from the one done before. Try to work in straight, even rows about an inch apart. This way you’re more likely to remember where the last injection was given.
Rotating injection sites
Many people with diabetes, children especially, develop “favourite” injection sites where there seems to be less pain and injections seem easier. If the same small area is used many times, the fat tissue below the skin swells, a condition called lipohypertrophy. This creates large bumps that absorb insulin poorly. They may go away in time when the site is left alone. Until the bumps have disappeared, inject into another area to get better insulin absorption. Sometimes many injections into the same site do not produce lipohypertrophy, but instead a hard area of scar tissue under the skin. These sites should also be avoided. At each clinic visit, a member of the diabetes team will look at the injection areas to help with site selection and the prevention of lumps or bumps.