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Insulin Pens: How to Give a Shot

Many people with diabetes need to take insulin to keep their blood glucose in a good range. This can be scary for some people, especially for the first time. The truth is that insulin shots are not painful as people imagine because the needles are short and thin. Insulin shots are given into fatty tissue below the skin. This is called a subcutaneous (sub-kyu-TAY-nee-us) injection.

The following instructions are for using most disposable insulin pens. If you are using a refillable pen, check with your doctor, diabetes educator or pharmacist on how to use. If you prefer to use a vial and syringe, refer to UPMC patient education page Insulin: How to Give a Shot.

ADVANTAGES of insulin pens:

  • Easy to use and carry
  • Looks like a pen for writing (discreet/not easily noticed)
  • No need to draw the insulin dose from a vial/bottle 
  • Can be used for most insulin types 
  • Doses can be easily dialed 
  • Less waste of expired insulin if not much insulin is used within time period designated (300 units in each pen)…see table end of this document 
  • To some people it may be less scary than a syringe

DISADVANTAGES:

  • Cannot mix different kinds of insulin together in a prescribed dose.

What You Will Need

Before you give the shot, you will need the following:

  • Insulin pen 
  • Alcohol swab, or cotton ball moistened with alcohol 
  • Pen needle (be sure your doctor writes your prescription for the pen needles as well as the specific type of insulin pen)
  • Hard plastic or metal container with a screw-on or tightly-secured lid

Parts of an Insulin Pen

Drawing of the parts of an insulin pen

How to Use

  1. Wash your hands.
  2. Check the drug label to be sure it is what your doctor prescribed. Check the expiration date on the pen. Do not use a drug that is past the expiration date. Also do not use if beyond number of days listed in table at end of this document once opened and in use. 
  3. Remove pen cap.
  4. Look at the insulin.
    • Short or rapid-acting insulin (Regular, Humalog, NovoLog, and Apidra) and Lantus or Levemir should appear clear. Do not use it if the drug appears to have pieces in it or is discolored.
    • Intermediate or mixed insulin (NPH, 75/25, 70/30, or 50/50) will appear cloudy and white. This type of insulin should be gently mixed before use. To do this, roll the pen between your hands. You must also turn the pen up and down ten times as shown in picture (Fig. 2).
    • Look at the insulin to be sure it is evenly mixed (cloudy white) with no clumping of particles.
  5. Wipe the tip of the pen where the needle will attach with an alcohol swab or a cotton ball moistened with alcohol. 
  6. Remove the protective pull tab form the needle and screw it onto the pen until snug (but not too tight).
  7. Remove both the plastic outer cap and inner needle cap.
  8. Look at the dose window and turn the dosage knob to ‘2’ units.
  9. Holding the pen with the needle pointing upwards, press the button until at least a drop of insulin appears. This is the ‘air shot’ or safety shot. Repeat this step if needed until a drop appears (see figure at right).
  10. Dial the number of units you need to take.
  11. Decide where on your body you will give the shot. Be sure to give the shot in a different place each time. You can stay in the same general area. Try to stay at least 1 inch from the last shot, any scars, and your belly button. Keep a diary to remember where your last shot was given (see image at right).
  12. To hold the pen, wrap your fingers around the pen with your thumb free to reach the dosing knob.
  13. With the other hand, gently pinch up the skin around where you will give the shot and hold firmly (‘pinching’ is most important when you are injecting in an area that does not have a lot of fat). You may not need to pinch if giving into a fatty area like the abdomen or if you are using a short needle (see image below).
  14. Insert the needle at a 45 to 90 degree angle. Ask your doctor or nurse which angle is best for you (longer needles may require 45 degree angle, where shorter needles may be given straight at a 90 degree angle). 
  15. While keeping needle under skin, press the button all the way returning to zero, and keep pressing for six to ten seconds (larger doses may require the whole ten seconds). Withdraw from the skin.
  16. If you bleed when the needle comes out, place an alcohol swab over the skin right away. Press gently on the swab until bleeding has stopped. Do not rub the skin. 
  17. Carefully replace outer needle cap over needle and unscrew until loosened (needle should come off pen inside needle cap). Never leave needle on pen when not in use.
  18. Throw away the needle in a hard plastic or metal container. Close the lid tightly. When the container is full, tape the lid down, and throw it away in the garbage, (but not with recyclables). Note: Check your town’s guidelines on syringe disposal.

Insulin Storage

Do not freeze insulin. Do not store insulin in sunlight or in a hot car. Take insulin onboard with you when traveling by airplane. Do not put insulin into luggage that will be stored away from you.

Insulin pens - Store unopened insulin pens in the refrigerator at a temperature of about 40 F (4.45 C). Insulin pens can be stored (if refrigerated) until the expiration date listed on the pen. Store opened pens at room temperature, but not above 86 F (30 C). Discard opened pens according to the following chart:

Regular

 28 days

Humalog (lispro)

 28 days

NovoLog (aspart)

 28 days

Lantus (glargine)

 28 days

Apidra (glulisine)

 28 days

NPH   

14 days

Humulin 70/30, Humalog Mix 75/25, Humalog 50/50

10 days
NovoLog Mix 70/30

14 days

Levemir (detemir)

 42 days

 

Most people find that taking insulin is not as hard as expected. When blood glucose is in control, most people feel better. This often happens when people with diabetes take insulin. If you have any questions about these instructions, call your doctor, nurse or pharmacist.

                                                                                                                                            Reviewed July 2013

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