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

Administering insulin may feel overwhelming at first. With practice, though, it can become a routine part of your day. Whether you’re administering insulin to yourself or a loved one, you can learn to do it safely and confidently.

Insulin can be administered in three easy steps: preparing the insulin dose, selecting and cleaning the site, and giving the injection with a pen or syringe. 

Here, we’ll take a closer look at each step and share tips to help make the process easier.

1. Gather your supplies and prepare your insulin

Many people feel uneasy around needles at first. But with some practice and support from your diabetes care team, administering insulin can become a seamless part of your daily routine. 

Let’s get started:

• Wash your hands and gather your supplies. 

• If you use cloudy insulin (such as intermediate or premixed insulin), gently roll the vial or pen 10 to 20 times to mix it. Don’t shake it. If your insulin is clear (such as fast-acting or long-acting insulin), you don’t need to mix it.

• 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.

• If you’re mixing clear and cloudy insulins, always draw up the clear insulin first.

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

2. How to administer insulin step by step

Once you've prepared your insulin, you're ready to give the injection. The steps are similar whether you're using an insulin pen or a syringe. Your healthcare team will show you the best technique for the type of insulin and delivery device you’re using.

Once your insulin is prepared, the next step is choosing where to give it. Insulin is injected into the fatty tissue just under the skin of your: 

• Abdomen

• Thigh

• Upper arm

• Buttocks

You’ll want to inject at least 1 inch away from your previous injection to avoid repeatedly using the same spot. Here’s what to do:

• Clean the skin if needed. If your skin is visibly dirty, wash it with soap and water. Many people also clean the injection site with an alcohol swab and allow it to dry before injecting.

• Insert the needle. Insert the needle into the skin using the technique recommended by your healthcare team. Most people using today's shorter pen needles can inject straight in at a 90-degree angle.

• Inject the insulin. Push the plunger or injection button all the way down until the full dose has been delivered.

• Wait before removing the needle. If you're using an insulin pen, count to 10 before removing the needle to help prevent insulin from leaking out. If you're using a syringe, remove the needle after the injection is complete.

• Dispose of the needle safely. Place used needles and syringes directly into a sharps container. Never reuse needles or throw loose sharps into the trash.

Always double-check the type of insulin and dose before injecting. If you use more than one type of insulin, taking a few extra seconds to confirm the label can help prevent medication errors.

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3. Choose the best injection site — and rotate it

Rotating injection sites is an important part of diabetes care. That’s because using the same site over and over can cause lipohypertrophy (scar tissue and lumps under the skin). This can make insulin work less predictably.

Aim to inject about 1 inch away from your last injection. You can rotate between different areas of your body, including your: 

• Arms

• Thighs

• Butt

• Belly

Switching sides from left-to-right can also prevent overuse of the same areas.

4. Know which insulin you're using and when to take it

Different types of insulin work at different speeds. Knowing which insulin you're taking and when to use it can help you get the best results from your treatment. Here’s what to know:

• Rapid-acting and short-acting insulin: Take around mealtimes to help decrease blood sugar spikes after eating. Many people take rapid-acting insulin about 10 to 15 minutes before a meal. But your diabetes care team will recommend the timing that's right for you.

• Intermediate-acting, long-acting, and ultra-long-acting insulin: Take once or twice daily, to help keep blood sugar steady between meals and overnight. 

Most people administer insulin with a pen or syringe, while others use an insulin pump or inhaled insulin. All are effective options. The best choice depends on your lifestyle, preferences, and treatment plan.

5. Monitor your blood sugar goals

Your blood sugar goals help determine when you need insulin and, for many people, how much insulin to take. Before starting insulin, your diabetes care team will set personalized glucose targets based on your age, health, and treatment plan.

For many adults, blood sugar goals are:

• Before meals: 80 mg/dL to 130 mg/dL

• One to 2 hours after meals: less than 180 mg/dL

To see whether you're staying within your target range, you'll need to check your blood sugar regularly using a blood glucose meter (glucometer) or a continuous glucose monitor (CGM). 

How often you check depends on your insulin regimen and the monitoring plan your diabetes care team recommends. Some people check their glucose after meals to better understand how food affects their glucose levels or when learning how to adjust mealtime insulin.

If your blood sugar is consistently above or below your target range, your diabetes care team may recommend adjusting your insulin dose or treatment plan.

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

One of the most important parts of using insulin safely is recognizing when blood sugar is too low or too high. Knowing the signs can help you treat the problem quickly and avoid serious complications. 

High and low blood sugar are common when you're taking insulin. Knowing the warning signs — and what to do next — can help you stay safe.

7. Your insulin dose may change over time

Every day is unique. That’s why it’s important to know how to adapt your diabetes treatment to your changing life. Managing diabetes gets a little more complicated when routines turn upside down with factors like: 

• Travel

• Illness

• Missed meals

• 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. Store your insulin properly so it keeps working

Make sure to store your insulin properly so it doesn’t lose effectiveness: 

• Keep it away from light and extreme temperatures (hot or cold). 

• Keep unopened insulin products in the fridge until you’re ready to use them. They’ll last longer in the fridge.

• Once opened, store your insulin pen at room temperature. An opened vial can be stored at room temperature or in the fridge. 

• Never use insulin that’s been frozen. Even if it looks normal, it may not work correctly and it’s not safe to use. 

9. Know when your insulin shouldn’t be used

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

Most rapid-acting and long-acting insulins are clear. Some intermediate-acting and premixed insulins are normally cloudy and should be gently rolled before use. Never use insulin that contains clumps, particles, or crystals, or that looks different than it normally does.

Even 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. Don’t use insulin past either of these dates. 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. Dispose of needles and supplies safely

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

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. 

Common mistakes when administering insulin (and how to avoid them)

Before every injection, take a few seconds to run through this checklist. These simple habits can help prevent some of the most common insulin administration mistakes.

Before you inject, make sure you have:

• The right insulin

• The right dose

• A new needle

• Insulin that’s in-date and not spoiled

Also, make sure to:

• Identify a different injection site than last time

• Check your blood sugar

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Written by:

Jewels Doskicz, RN, BA

Jewels Doskicz, RN, is an Arizona-based registered nurse with more than 20 years of hospital-wide clinical nursing experience. She has spent over a decade in medical writing and editing, with a focus on diabetes and autoimmune disease.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

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