Drawing Up Insulin Steps With Regular and Nph

Insulin, Using and Injecting

Insulin: How to Use and Where to Inject

You give yourself insulin as a shot (injection). It's injected in the fatty layer under the skin (subcutaneous). Some people use an implanted device called an insulin pump. Others inject insulin using prefilled "pens." Your healthcare team will teach you how to use insulin. Make sure you follow all instructions about when and where you use it.

Where to inject your insulin

  • Insulin is most often injected in belly (abdominal) fat. That is where it is absorbed fastest.
  • Change the injection site each time you give yourself insulin. This helps prevent problems.
  • Plan out how you will move from site to site.
  • Leave at least 2 inches around your belly button (navel).

Ask your healthcare provider to teach you about rotating your injection site. This will help prevent a bump from forming under the skin from using the same spot. Also ask how to prevent injecting it into the muscle. Injecting the muscle or into the bump can lead to incorrect insulin absorption.

Human outlines showing injection sites on front and back of torso, front of thighs, and back of arms.
Injection sites in adults include the belly (abdomen), front of thighs, back of upper arms and upper buttocks.

When to inject your insulin

  • Follow your healthcare provider's instructions about when to give yourself insulin.
  • It's very important to time your insulin shots with meals or snacks.

Getting ready to inject insulin from a bottle

  • Wash your hands. Use soap and clean, running water.
  • Check the expiration date on the insulin. Don't use expired insulin.
  • Look at the insulin. Clear insulin should not be discolored or have crystals. Cloudy insulin should not have clumps or crystals stuck to the side of the vial or pen.
  • Wipe the top of the insulin bottle (vial) with alcohol.

Single-dose prep

  1. Pull back the plunger until the end of the plunger is even with the number of units of insulin you take. Always read the numbers of units of insulin at your eye level.
  2. Put the needle into the top of the bottle. Then push the plunger in all the way. This pushes air into the insulin bottle.
  3. Turn the bottle and syringe upside down. The bottle will be on top.
  4. Hold the needle and bottle straight up and down. Check that the needle is in the insulin.
  5. Pull back on the plunger until the end of the plunger is even with the number of units of insulin you take.
  6. Remove the needle. Then tap the syringe with a fingertip to remove any air bubbles.

1. Hands holding a syringe and vial with insulin. Syringe is being inserted in vial. 2. Hand holding syringe and vial of insulin. Syringe is underneath vial with plunger pulled out.

Mixed-dose prep

Important: Some insulins should not be mixed. Always check with your healthcare provider before mixing insulin.

  1. Before you start, add up the 2 insulin doses. This is so that you will know the total of the 2 doses. For example, you need 6 units of regular (clear) insulin and 7 units of NPH (cloudy). Your total will be 13 units.
  2. Pull back the plunger until the end of the plunger is even with the number of units of insulin you take. Always read the numbers of units of insulin at your eye level.
  3. Put the needle into the top of the bottle. Then push the plunger in all the way. This pushes air into the insulin bottle.
  4. If you use both regular and NPH insulin in a single syringe, carefully remove the needle from the first bottle. Repeat the above steps for second bottle.
  5. With both bottles pre-filled with air, you are now ready to draw up the insulin. Always draw up regular (clear) insulin before NPH (cloudy). Put the needle in the bottle of regular (clear) insulin.
  6. Turn the bottle and syringe upside down. The bottle will be on top.
  7. Hold the needle and bottle straight up and down. Check that the needle is in the insulin.
  8. Pull back on the plunger until the end of the plunger is even with the number of units of regular insulin you take.
  9. Remove the needle from the regular (clear) insulin. Insert it into the NPH (cloudy) insulin bottle. Be careful not to push on the plunger.
  10. Turn the bottle and syringe upside down. The bottle will be on top.
  11. Hold the needle and bottle straight up and down. Check that the needle is in the insulin.
  12. Pull back on the plunger until the end of the plunger is even with the total number of units you are taking. This number is the total of the 2 insulin doses together as shown in step 1 above.
  13. Remove the needle. Then tap the syringe with a fingertip to remove any air bubbles.

Injecting the insulin

  • Gently pinch up about 1 inch of skin. Don't squeeze the skin.
  • Put the needle straight into the skin, at a right-hand (90-degree) angle. Don't slant it.
  • Push in the plunger. Press until the syringe is empty. Let go of the skin. Then remove the needle. Don't rub the site after you remove the needle.Closeup of abdomen showing hands giving subcutaneous injection in belly fat.

Getting rid of the syringe

  • Put the needle and syringe in a sharps container. Don't recap the needle.
  • You can buy a sharps container at a drugstore or medical supply store. Or you can also use an empty laundry detergent bottle or any other puncture-proof container and lid.
  • When the sharps container is full, put it into a garbage bag and secure the top. Label the bag "needles" or "sharps."
  • Call your local waste company to ask about removing the sharps container. You can also check with the Coalition for Safe Community Needle Disposal at 800-643-1643 or www.safeneedledisposal.org.

Storing your insulin

  • Keep unopened insulin bottles in the refrigerator. An open bottle can be stored at room temperature, such as on the kitchen counter. But don't let the insulin get too hot. Always keep it below 86°F (30°C). And never let it freeze.
  • Always use insulin before the expiration date on the bottle. Throw expired bottles away.
  • Use insulin within 28 days of opening the bottle. After 28 days, throw it away. To remember, write the date you opened it on the bottle.
  • When you travel, take all of your diabetes supplies. Put them in a bag made to protect insulin from heat and cold. Always keep them with you. You will have what you need if there is a delay or your suitcase is lost.
  • Never leave insulin in the car. It can get too hot or too cold.

StayWell last reviewed this educational content on 11/1/2018

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.


Drawing Up Insulin Steps With Regular and Nph

Source: https://mountnittany.org/wellness-article/insulin-using-and-injecting

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