How to Inject Insulin with a Syringe in 5 Easy Steps

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Before there were insulin pens, people would inject this diabetes medication with an insulin vial and syringe. Both methods of injecting insulin are used by many people living with Type 1 or Type 2 diabetes. While insulin pens are gaining more popularity, some people still prefer to use a vial and syringe due to having more hands-on control with their doses.

Injecting insulin with a syringe may seem intimidating at first. But with practice, you'll likely feel more confident and comfortable with the process. Below, we'll go over five steps on how to inject insulin with a syringe.

1. Gather your supplies and wash your hands

The first thing you should do to prepare to inject insulin with a syringe is to gather all of your supplies. Supplies to gather include:

• Alcohol swabs

• An unused syringe

• A sharps container (or suitable alternative)

• The vial of insulin you'll be injecting

• Gauze pads or cotton balls

• A bandage

Insulin syringes already contain a needle. You don't need to purchase "pen needles" to attach to your syringe. Pen needles are only used for insulin pens.

After gathering supplies it's recommended to wash your hands with soap and warm water. Make sure to wash your hands thoroughly for at least 20 seconds and dry your hands completely. If you don't have access to soap and water, alcohol-based hand sanitizer is a good alternative.

Before drawing up insulin with your syringe, check the appearance of the insulin inside your vial. If the liquid is discolored or has clumps or particles, don't use it. Similarly, if your insulin has expired, you shouldn't use it. Contact your pharmacy for a new vial.

Good to know: Most insulins are clear and colorless. But some have a cloudy appearance. Ask your prescriber or pharmacist if you're unsure whether your insulin is supposed to be cloudy.

2. Draw up your dose into the syringe

When opening a new insulin vial, take the protective plastic cap off of the vial. After removing it, you can throw the cap away in your normal trash. Underneath the cap is a rubber stopper that should remain attached to the vial as long as you use it. Clean this stopper by wiping it with an alcohol swab before each injection.

After you open a new insulin vial, consider writing down the day you opened it on the package. Insulin has a shorter shelf life once the rubber stopper is punctured. This shelf-life is usually listed on the box your insulin comes in. But if you're unsure how long your opened insulin vial is good for, ask your pharmacist.

Next, pick up your unused syringe. Carefully pull off the protective cap to expose the needle. The plunger may also have a cap that needs to be removed - this varies by syringe type. Pull back the plunger to the line on the syringe barrel that matches the number of units you'll be injecting. This fills the syringe with air, which you'll inject into the vial.

Hold the vial steady on a hard surface with your nondominant hand. With your dominant hand, insert the needle at a 90-degree angle into the vial's rubber stopper. Then, slowly push the plunger towards the syringe barrel.

While holding onto both items, flip the vial and syringe upside down. With your nondominant hand, place the vial's neck between your index and middle finger. Then, use your thumb and ring finger to hold onto the syringe barrel. This will free up your dominant hand to be able to draw your dose into the syringe.

Use your dominant hand to pull the plunger down to the line on the barrel that marks your insulin dose.

Check your syringe for air bubbles. To get rid of air bubbles, use a finger on your dominant hand to gently tap or "flick" the syringe barrel. This should cause the air bubbles to float to the top. Then, slowly push the plunger up to remove the air bubbles through the needle tip.

Flip the vial-syringe combo right-side up again. You can now remove the syringe from the vial.

Good to know: Some insulins require you to mix them before drawing up your dose. If this is the case for you, gently roll the vial back and forth between your hands several times. Your prescriber or pharmacist can tell you if your insulin requires mixing.

3. Pick your injection site

Insulin is a subcutaneous (beneath the skin) injection. There are four areas where it can be administered:

• The stomach (at least 2 inches away from your belly button)

• The front of the thigh

• The back of the upper arm

• The buttocks

Many people prefer to self-inject insulin in their stomach or thighs. The upper arm and buttocks are also available injection sites, but these areas are difficult to inject on your own.

All four insulin injection sites are acceptable to use. But insulin enters the bloodstream a little faster when you inject in the stomach. For consistent effects, try to use the same area of the body for every dose.

Wipe the area of skin that you'll be injecting with an alcohol swab. Allow the skin to air dry before giving your injection. Don't blow on it, as this could contaminate your skin with germs that live naturally in your mouth.

Be sure to rotate injection sites with each injection though. For example, you may use the left side of the stomach for one injection and then use the right side for the next one. Doing this helps prevent irritation and lipohypertrophy (when the skin gets tougher to inject). It's recommended to keep your current injection at least one finger width apart from your last injection.

Which insulin injection site is the least painful?

For many people, the stomach is the least painful insulin injection site. But keep in mind everyone's experience is different. You may find that a different body area is more comfortable for you to use.

There are other factors that can cause discomfort during injection, too. Administering large volumes of insulin tends to be more painful than smaller amounts. What's more, it may be less painful to inject room temperature insulin compared to insulin that's cold.

4. Give the injection

When you're ready for the injection, gently pinch about 1 inch of skin at the injection site with your nondominant hand. Hold the syringe like a pencil with your dominant hand. When you're ready, insert the needle into your skin at a 90-degree angle. After the needle is fully inserted, let go of the pinched skin.

In a slow and steady motion, push the plunger in to administer the insulin. After the insulin is fully injected, wait 5 seconds before removing the syringe. Then, pull the needle out of your skin.

You may notice a small amount of blood where you injected your insulin. If this happens, gently press a gauze pad or cotton ball to the area for a few seconds. This should stop the bleeding.

5. Dispose of the insulin syringe

After injecting your insulin, throw the used syringe into a proper disposal container. Do not recap the needle. It's easy to accidentally stick yourself with the needle while recapping needles. Uncapped, used syringes can go directly into your disposal container. Used or empty vials of insulin can be discarded in your normal trash.

An FDA-cleared sharps container is ideal to use for insulin syringe and needle disposal. If you don't have a sharps container, any heavy-duty plastic container that has a tight-fitting lid is an acceptable backup. A plastic laundry detergent container with its lid is an example of a sharps container alternative.

What should you not do when injecting insulin?

When injecting insulin with a syringe there are a few things you should avoid:

• Don't reuse syringes. Reusing syringes can be painful and can increase your risk of infection.

• Don't change your insulin dose on your own. Giving yourself too much could cause hypoglycemia, or low blood glucose (sugar). And giving too little insulin can cause hyperglycemia (high blood glucose). Your prescriber will help with dose changes if they think it's needed.

• Don't mix two different types of insulin together without your prescriber's OK. Mixing two insulins together in one syringe may interfere with how they work.

• Don't use insulin that has expired. Insulin begins to break down over time and becomes less effective.

• Don't use insulin that appears discolored or has particles in it. These are signs that the insulin may be unsafe to inject.

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