How to Administer Insulin: 10 Things to Know Before You Start

There are a variety of medications used to manage diabetes. Insulin is one of them. It helps the body use and store carbohydrates from your diet. 

If you have Type 1 diabetes, insulin administration is necessary for life. That’s because your body mistakenly attacks its insulin-producing cells. If you have Type 2 diabetes, your body doesn’t make enough insulin or respond to it as it should. So to keep blood sugar within a target range, some people need to take insulin alone or along with oral or other diabetes medications.

Over 7 million people in the U.S. take insulin every day to manage their diabetes. Taking insulin injections may feel intimidating at first. But, in time, you’ll begin to feel more comfortable and confident. 

Let’s look at 10 important things to know before starting insulin.

1. Know your blood sugar levels and goals

Before you start insulin, it’s important to know your blood sugar goals. This usually includes two numbers: 

• Blood glucose: This is how much sugar is in your blood at a specific moment in time. You can use a glucometer or continuous glucose monitor (CGM) to monitor your glucose levels. The target range is typically 80-130 mg/dL before meals and less than 180 mg/dL after meals.

• Hemoglobin A1C (HbA1c or A1C): A1C testing gives an estimate of your blood sugar level over the past 3 months. The A1C target is usually less than 7% for most adults. Your provider will measure your A1C two to four times a year. As a general rule, this timing depends on how stable your glucose is and if you’re meeting treatment goals. 

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Your care team will set your glucose target range and A1C goals. These depend on your age and individual health needs. 

2. Monitor your blood sugar

Monitoring your glucose will help to make sure that your treatment plan is working. Glucose readings outside of your target range can be signs that you need to adjust your insulin dose. 

When taking insulin, you need to check your glucose several times a day, at minimum. This includes first thing in the morning, before meals, and at bedtime. Checking your glucose 2 hours after meals can help you to make small adjustments to your insulin routine.

3. Know your different insulin options

Insulin can be given a few different ways: injection (syringe or pen), inhaler, or pump. Knowing your options can help you with a budget-friendly, easy-to-use choice that fits your lifestyle.

While some people choose a syringe, others may opt for an insulin pen. Insulin pens are convenient and offer a more discreet and simplified way of administering insulin.  

Others may choose to wear an insulin pump. There are a variety of insulin pumps with different features that help make diabetes management easier. Simply put, an insulin pump continuously delivers small amounts of rapid-acting insulin called a “basal rate.” You’ll also give “bolus” insulin as a single dose or burst of insulin. This is used for meals and to correct out-of-range glucose levels.

Diabetes can be well managed with any delivery tool you choose — it all depends on your personal preference.  

4. Understand when to take insulin

Insulins are classified by how fast they can lower your blood glucose (onset) and how long their effects last (duration). Most people who don’t use an insulin pump need to use a few different types of insulin as part of their treatment. 

Typically, people have one long-acting insulin (basal) and another short- or rapid-acting insulin (bolus). Understanding how they work (specifically, their onset and duration) will help you to better match your insulin use to your insulin needs:

• Rapid-acting and short-acting injections: These are taken before meals because they work quickly to stop a rise in blood sugar after a meal. 

• Long-acting and ultra long-acting insulins: These are taken once a day. This type of insulin works in the background all day long to help keep glucose levels stable when you’re not eating. 

For your safety, It’s important to follow your healthcare provider’s instructions for taking insulin. 

5. Know how to give yourself the right amount of insulin

Giving yourself the right amount of insulin each time is important. Too little insulin can cause high blood glucose (hyperglycemia) and too much insulin can cause low blood sugar (hypoglycemia).

When giving insulin, keep these tips in mind:

• Double check your insulin. If you use more than one type of insulin, always check the label on your vial or pen before injecting yourself. This will help to make sure that you’re using the right kind of insulin and at the right time. 

• Remove air bubbles. If you’re using a syringe, always check for air bubbles when drawing up an insulin dose. If you see air bubbles, use your finger to tap them to the top of the syringe, and then push them out slowly with the plunger. This is important because air in the syringe can reduce the amount of insulin you give yourself.

• Pause after injecting. If you’re using an insulin pen, insulin can sometimes leak out of the skin after an injection. To avoid this, count to 10 before removing the needle from your skin.

And, if you have a visual impairment, ask your healthcare provider or pharmacist about insulin delivery aids and sound-enabled glucometers, CGMs, and pumps. 

6. Know how to recognize and respond to high and low blood sugar levels

Recognizing the signs and symptoms of high and low blood sugar is a lifesaving skill when you have diabetes, especially if you take insulin. So we’re here to help you know the signs and what to do when you have high or low blood sugar.  

Low blood sugar 

Hypoglycemia is when your blood sugar is less than 70. Common signs and symptoms of low blood sugar are:

• Sweatiness

• Shaking 

• Dizziness 

• Confusion 

• Fast heartbeat

• Hunger

• Feeling weak or tired

• Feeling nervous or upset

• Headache

The “15-15 rule” is a helpful way to remember how to treat low blood sugar. Here’s what to do:

• Take 15 grams of fast-acting carbohydrates (4 glucose tabs).

• Wait 15 minutes.

• Check your blood glucose level again. If it’s still below 70, repeat the cycle.

But sometimes the 15-15 rule isn’t enough to treat very low blood sugar. Severe hypoglycemia can cause a loss of consciousness and be life-threatening. If prescribed, give glucagon and call 911 for emergency care. 

High blood sugar

Hyperglycemia is when your blood sugar is above 180 or outside of your target range. Common signs and symptoms of high blood sugar are:

• Dry mouth 

• Increased thirst

• Frequent urination 

• Headache

• Blurry vision

• Nausea

• Weakness or fatigue (feeling very tired)

• Flu-like symptoms, like feeling achy or unusually warm or cold

Your diabetes care team will give you instructions on how to safely lower your blood sugar if it gets too high. Since it can be stressful to experience high blood sugar, try to familiarize yourself with the plan ahead of time. 

If your blood sugar is still high after following your treatment plan, contact your healthcare provider or get emergency care. Untreated hyperglycemia can be life-threatening. Get medical attention right away if you experience: 

• Shortness of breath

• Fruity-smelling breath

• Nausea and vomiting

7. Know how to adjust your insulin to changes in your routine

Every day is unique. That’s why it’s important to know how to adapt your diabetes management to your changing life. Managing diabetes gets a little more complicated when routines turn upside down with travel, illness, missed meals, or increased physical activity. 

It pays to check your glucose more frequently when your normal routine changes. This lets you make small adjustments to your insulin dose to prevent big changes in blood glucose. Your diabetes care team can provide advice on planning ahead and making adjustments in unexpected situations. 

8. Understand how to store your insulin properly

It’s important to know how to store your insulin properly. This includes keeping it away from light and extreme temperatures (hot or cold) so it doesn’t lose effectiveness. 

Never use insulin that’s been frozen. Even if it looks normal, it’s not safe to use. That’s because when insulin is exposed to freezing temperatures, it begins to break down. 

Always keep unopened insulin products in the fridge until you’re ready to use them. You can store opened insulin vials in the refrigerator or at room temperature. After you open and use an insulin pen, store it at room temperature. 

9. Know when your insulin is expired or shouldn’t be used

Before using insulin, always make sure it’s not spoiled. This can happen when it’s stored improperly or outdated.

Insulin should look clear. So don’t use it if it looks cloudy or has crystals and clumps in it. 

But expired insulin can look normal, so be sure to check two important dates:

• Expiration date: This is labeled on the box, and it’s how long unopened insulin is good for.

• Use-by date: This is how long you can use insulin after opening it. You’ll need to write down this date or set a reminder on your calendar or phone.

Both of these dates depend on your insulin product and how it’s stored before and after opening. Do not use insulin past either of these dates. That’s because insulin breaks down over time and may not work as well. If you have any questions, be sure to ask your pharmacist about these dates.

10. Know how and where to dispose of your insulin supplies

Some insulin supplies need to puncture your skin to deliver medication (needles and syringes) or to get a blood sample (fingerstick devices, or lancets). These are “sharps,” and they can be dangerous when not properly handled. So to keep yourself and others safe, make sure to properly dispose of them. 

The FDA recommends placing all needles in a sharps container after using them. You can buy FDA-cleared containers at your pharmacy or online. 

The American Diabetes Association (ADA) recommends making your own sharps container. For example, you can use a laundry detergent bottle. Whatever you choose, the container should be made of heavy-duty plastic and also be leak- and puncture-resistant. And you should be able to close it with a tight-fitting lid.  

Check the rules for disposing sharps containers where you live, since they can vary  depending on your location. 

Tips to make injecting insulin easier

Many people feel uneasy around sharps. But with some practice and expert guidance, you can make insulin administration a seamless part of your day. 

You can check out our guide on how to give yourself a shot. The basic steps for using a syringe and vial are similar to those for how to use an insulin pen:

• Wash your hands and gather your supplies. 

• Gently roll the vial or pen if using long-acting insulin (skip this if using fast-acting, clear insulin).

• Double check the insulin vial for the type of insulin and use-by and expiration dates.

• Clean the top of the vial with an alcohol swab (pop off the top if using a new vial). Or, for a pen, attach a new pen needle.

• For a syringe, pull back air to equal the amount of insulin you’ll be drawing up and inject it into the vial. Then turn the vial upside down (with the syringe in it) and draw up the insulin you need. Check for bubbles, and tap them gently to the top. Push the plunger to get them out, then remove the needle from the vial.

• For a pen, prime the pen with 2 units of insulin (you should see a drop of insulin) and then dial up your prescribed dose.

• Double check the dose, clean the injection site with alcohol, pinch the skin, and inject into the abdomen, arms, top of butt, or thigh.

• If using a pen, count to 10 before pulling the needle out of your skin (so no insulin leaks out).

Beyond the basics, here are a few tips to make injecting insulin even easier:

• Set a reminder alarm until taking insulin injections becomes a habit. 

• Keep a log to record injections — include the time, dose, and site where you gave it.

• Room temperature insulin can burn less, so if it’s bothering you, let the syringe warm up on the counter before injecting.

• If the needle hurts, gently ice the area first, then clean with an alcohol wipe.

• Have a friend or family member give you insulin in hard-to-reach places.

• Lean your arm on a chair back or corner of a table to push the fatty area into reach.

• Point your toes together to relax your buttocks before an injection.

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Written by:

Jewels Doskicz, RN, BA

Jewels Doskicz, RN, BA, is an Arizona-based registered nurse with 22 years of hospital-wide clinical nursing experience and 11 years of medical writing and editing experience. She was a former healthcare content creator for a digital health tool at HealthLoop and director of clinical content operations at GetWellNetwork.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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