Getting started on Insulin

Injection sites

Knowing where to give your injection and how to rotate your injection sites will make your injections safer, more comfortable and more effective.

Your injection sites have to be easy to reach when you perform an injection and should take into account your own lifestyle. These are usually abdomen buttocksand thigh. Discuss the most suitable injection sites and site rotation regime with your diabetes specialist nurse, doctor or practice nurse.

Rotating between injection sites

Each injection site has a different absorption pattern and in order to reliably predict the effect of a dose of insulin, you should try to keep a consistent site for each time of the day. For example if you decide to use your abdomen for your morning injection, you should try not to give the morning injection in the thigh or elsewhere, but rotate around the abdomen. Repeated insulin injections at the same place have been shown to be one of the causes of a fatty tissue disorder known as “lypodystrophy”.

Not only are these “lipo’s” disfiguring, they are also responsible for erratic and unpredictable absorption of insulin.

Storing insulin

• The insulin that you are currently using should be kept at room temperature (below 25º - 30º C depending on your insulin – check the insulin box). This will make the injection more comfortable as cold insulin can sting. Your spare insulin, however, must be kept in the fridge (2º - 8º C) in order for it to last until its expiry date.
• Insulin can be kept at room temperature for 28 days after which point it must be discarded.
• Do not freeze your insulin, as this will damage it. If you suspect that it has been frozen it must be discarded.
• Always check the expiry date of insulin before using it. The expiry date is only valid if the insulin has been stored correctly in the fridge.

General recommendations

Keeping a pen needle on an insulin pen leaves an open passage to the insulin. Therefore, it is important to remove the needle after each injection. This prevents air entry into the cartridge, insulin leakage out of the cartridge and clogging of the needle.

• Whatever the insulin device used, we advise you not to inject through clothes for the following reasons:
• It is difficult to perform a correct lifted skin fold when injecting through clothes. Clothing fabric removes the lubricant and can damage the needle tip, which increase pain and discomfort when injecting.
• It is not possible to inspect the injection site for bleeding, insulin leakage or infection when injecting through clothes.
• Whatever the insulin device used, needle reuse leads to damage and loss of lubricant. This will increase pain and discomfort during the injection.
• Ensure that you use a new needle every time you inject.

Safe Needle Disposal

If you use an insulin syringe or pen you need to ensure that your needle/sharps are safe from harm to yourself and others. There are different schemes and arrangements in place for the safe disposal of your sharps disposal box once it is full depending on where you live.

If you live in the Liverpool, Sefton or Knowsley you can ask your diabetes specialist nurse, practice nurse or district nurse to register you on your Council’s sharps box scheme. You will receive a sharps box from your nurse and then when it is two-thirds full call the appropriate number below and ask for collection and replacement of the sharps box.

• If you live in the Liverpool area you should ring 0151 233 3001
• If you live in the Sefton area you should ring 08451400845
• If you live in the Knowsley area you should ring 0151 443 2400

Advice

Safety

• Never share syringes or finger-pricking devices.
• Keep all your needles and glucose monitoring equipment clean, bloodstain free and out of reach of children at all times.
• Never try to retrieve anything once it has been put in the sharps disposal box.

Storage

• Needles, syringes and lancets must not be disposed of in fizzy drinks cans, plastic bottles or similar containers as they are not safe for disposal and could result in injury to others. They are clinical waste and need a special system for disposal
• You can dispose of your needles, syringes and lancets in a sharps disposal box. A clipper, a device that enables you to safely snap off sharps from your syringes/pens, can also be useful as a method of storage. The clipper needs to be disposed of in a sharps disposal box when full in accordance with your local guidelines for clinical waste disposal.
• Lancets cannot be disposed of using clippers as these are not designed to remove the lancet needle.

Travel

• When travelling by air you can check with your GP to ensure your disposal equipment such as clippers and sharps disposal box are included in your accompanying letter regarding your treatment and equipment.
• Information about the guidelines for disposal in the country you are visiting can be sought from the Association for Diabetes in the country you are visiting.
• Keep sharps boxes out of reach of children.

Diabetes Centre
Royal Liverpool University Hospital
Prescot Street
Liverpool
L7 8XP

0151 706 2829

Visit the Feet for life website here

Visit the Diabetes.Org website here

Visit the Medic Direct website here

Visit the Patient.co.uk website here

Visit the Health In Focus website here

Visit the NHS direct website here