8 Tips for Diabetes Medication Self-Injections

In the United States, many adults living with diabetes use insulin injections or newer non-insulin injections to help keep their blood glucose levels under control. About one third of them, however, don’t inject their medication correctly. That means they don’t get the right amount of medication, their blood sugar levels swing too high or too low, and their diabetes symptoms get worse. Here are some easy ways to improve your technique.

Some people struggle with taking their diabetes medication injections as prescribed because they’re afraid of needles. Fortunately, there are several ways to calm your fears. Ask your doctor if “exposure-based therapy” would help. It involves getting more comfortable with needles progressively—from just looking at a syringe without a needle, to looking at one with a needle, to holding one with a needle, and so on. Counseling can help, too.

If the size of the needle is causing concern, you do have options–shorter needles are available! Experts used to think shorter needles weren’t effective for people who were overweight, but recent research has busted that myth. And no matter your weight, many studies have shown shorter needles are just as effective in delivering diabetes medication as longer needles. If your current needles are five to eight millimeters long, ask your doctor if it would be appropriate for you to switch to a four-millimeter needle. This needle is about as thin as a couple strands of hair.

Many people find a pen easier to handle, less painful, and more convenient. Whether or not a pen option is better for you will depend on the type of medication you take and other personal factors. Pens are available for insulin and the two different types of non-insulin injectable medications: GLP-1 receptor agonists and amylin analogues. GLP-1 receptor agonists stimulate your body to produce insulin. Amylin analogues slow the movement of food through your stomach to balance after-meal blood glucose levels. A pen is easy and quick to use, so if your syringe is causing problems, ask your doctor if it’s possible to switch to a medication that comes in pen form.

The temperature of both your medication and your body affects how fast you absorb injected diabetes medication. You don’t want your body to absorb it faster than intended. Insulin and GLP-1 receptor agonists should be kept refrigerated until they’re opened, then kept at room temperature. Amylin analogues should be kept refrigerated until opened, and then it can be kept at either room temperature or refrigerated. Hold off on diabetes injections after exercise or a hot bath or shower.

Different medications and devices come with specific pre-injection steps. These may involve turning a dial on a pen to prime it or releasing a little medication before you inject it. Insulin pens and vials need to be tipped or rolled about 10 to 20 times before you use them. When you’re finished, the insulin should look clear, not cloudy. Check for air bubbles before you inject diabetes medication, and don’t hesitate to ask your doctor to demonstrate the entire process.

Where you inject diabetes medication on your body affects the absorption rate. Research points to the abdomen as the ideal site for insulin, but it’s not the only effective option. Ask your doctor about the best spot for you. Some people find it easier to inject through clothes; this method has been shown to be safe and effective, as long as the clothes are clean and not thicker than one layer. Before you try this, get your doctor’s opinion.

You doctor may recommend injecting your diabetes medication in the abdomen, buttocks, upper thigh, or upper arm. This is meant to be a general area. Avoid injecting yourself in the exact same place, because that can cause lipohypertrophy—lumpy or toughened skin that decreases medication absorption. Nearly half of those who inject themselves with insulin experience lipohypertrophy, but you can avoid it by changing up where you inject. Be sure to avoid injecting diabetes medication into moles or scars, too.

Some people living with diabetes are so worried about hypoglycemia (low blood sugar) that they don’t take their diabetes medication injections. Hypoglycemia isn’t a common side effect of biologic injectables, but it is for insulin therapy. About 30% of people using insulin therapy experience it. While the hypoglycemia is not usually severe, you may want to keep a snack with at least 15 grams of carbohydrates on hand, or your doctor may prescribe glucagon injections in case of emergency.