When used properly, insulin can be an essential tool for managing type 2 diabetes. Here’s what to do and what not to do when it comes to injecting insulin.
When diet, exercise, and oral medications aren’t enough to manage type 2 diabetes, it may be time for insulin. The most important aspect of insulin therapy is using it exactly as prescribed.
Still, remembering all the little details can be tricky, and certain mistakes are common. By following these dos and don’ts, you can avoid medication mishaps and keep insulin working as it should.
DO: Rotate the insertion site (while keeping the body part consistent). “Insulin is absorbed at different speeds depending on where you inject it, so it’s best to consistently use the same part of the body for each of your daily injections,” says Doreen Riccelli, BSN, director of education at Lake Pointe Medical Center in Rowlett, Texas. “For example, don’t inject yourself in the abdomen on Saturday and in the thigh on Sunday,” she says. “If you choose the thigh for your evening injection, then use the thigh for all of your evening injections.”
That said, within the specific body area, it’s important to move each injection site at least one finger’s width from the previous injection site to avoid the creation of hard lumps or extra fat deposits, which could change the way insulin is absorbed.
DON’T: Store insulin incorrectly. Insulin can generally be stored at room temperature (59 to 86° F), either opened or unopened, for one month. When kept in the refrigerator, unopened bottles last until the expiration date printed on the bottle. Opened bottles stored in the refrigerator should be used or discarded after a month.
Never store insulin in direct sunlight, in the freezer, or near heating or air conditioning vents, ovens, or radiators. It should also not be left in a very warm or cold car. Store it in an insulated case if needed.
DO: Work closely with your doctor. Finding a routine that works for your type 2 diabetes is key — and that process should involve your doctor. “It’s important to communicate with your doctor about your diabetes care,” says Kevin J. Goist, MD, a primary care doctor at the Ohio State University Wexner Medical Center in Columbus. “This includes being open and honest about your diet, how often you check your blood sugar, what your home readings are, what doses of insulin you’re taking, and if you’re having any concerning side effects. Not doing so can have disastrous consequences,” he says. For example, if your blood sugar is elevated because you’re not taking your insulin as directed and your doctor increases your dose based on this misinformation, it could result in dangerously low blood sugar (hypoglycemia) once you start taking insulin again.
DON’T: Inject insulin just anywhere. Insulin should be injected into the fat just underneath the skin rather than into muscle, which can lead to quicker insulin action and greater risk of low blood sugar. The stomach, thighs, buttocks, and upper arms are common injection sites because of their higher fat content.
DO: Time insulin injections with meals. If you take long-acting insulin, this may not be necessary. But if you use shorter-acting or mealtime insulin, check your blood sugar prior to a meal and then give yourself the proper amount of insulin shortly before eating. And if you skip a meal, you shouldn’t administer insulin. Only your doctor can determine what the right insulin schedule is for you.
DON’T: Feel compelled to stick with the same insulin-delivery device. “There are many options for taking insulin, including pens, pumps, and syringes,” says Maire Robacker, RN, CDE, a diabetes clinical specialist at the Scripps Whittier Diabetes Institute in San Diego. Your doctor can help you determine what’s best for your type 2 diabetes and your lifestyle. If one type of device isn’t working well for you, consider trying another.
DO: Know the warning signs of an insulin reaction. Low blood sugar occurs when there’s too much insulin in your bloodstream and not enough sugar reaching your brain and muscles. Low blood sugar can come on very quickly and symptoms may include dizziness, shakiness, sweating, and rapid heartbeat. You should treat it immediately by consuming a small amount of sugar, such as half a cup of juice or a glucose tablet (“sugar pill”). Work with your doctor to develop an action plan in case an insulin reaction occurs.
High blood sugar (hyperglycemia) can also occur. This condition can develop slowly over several days when the body doesn’t have enough insulin and blood sugar levels increase. Symptoms include increased thirst and urination, large amounts of sugar in the blood, weakness, labored breathing, nausea, and vomiting. Any time you suspect high blood sugar, call your doctor.
DO: Be prepared. “Be sure that your glucometer is functioning correctly, that you have testing strips that are stored properly and aren’t expired, and that you have control solution to test the accuracy of your glucometer and test strips,” Dr. Goist says. He also suggests wearing a medical alert bracelet stating that you have type 2 diabetes or keeping a card in your wallet near your driver’s license or other personal identification card to inform others in case of emergency.