Fearful of Insulin Injections? Your Top 5 Questions, Answered

Learning about diabetes and insulin therapy will boost your confidence

When you have type 1 diabetes, your doctor will prescribe insulin therapy for you. That’s because your body produces little or none of this critical hormone. (In contrast, if you have type 2 diabetes, insulin therapy typically comes into play only when other treatments aren’t effective.)

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You may feel some fear about starting insulin therapy. It’s perfectly natural to worry about starting injections. But they’re key to your treatment. Insulin will keep you from feeling fatigued and will help you prevent complications, including heart disease and organ damage.

So doing your best to take your insulin as your doctor directs is important. Educating yourself about diabetes and about the injection process is a good first step. It will help you gain the confidence you need to follow through with your treatment plan.

Here’s a primer on insulin, why you might need it and how to use it correctly.

1. Why do you have to inject insulin?

Insulin injections are your most effective way to keep your blood glucose levels in a healthy range when lifestyle changes and other medications cannot.

Because of the way your body breaks insulin down, you can’t take it in pill form. So insulin must be injected into the fatty layer of your skin. Although giving yourself shots poses a challenge at first, you will grow used to it.

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Depending on your needs, your doctor will prescribe insulin in either short-term or long-term doses:

  • Short-term insulin: You will take this several times a day to manage blood sugar spikes when you eat.
  • Long-term insulin: You will take this once daily to cover blood sugar spikes over 24 hours.

Studies show that, once they start insulin injections, many patients intentionally skip doses. It’s important to view insulin injections not as a punishment, but as your key to good health.

2. What is the proper injection technique?

Learning to give yourself a shot is sometimes daunting. Many people opt to use the newer insulin pens or inhalers to avoid shots. But if you need injections, you can make the process more comfortable by remembering to:

  • Throw away any needle that touches any surface before you inject to avoid contamination. Start over with a new one.
  • Insert the needle at a 90-degree angle.
  • Insert it into a skin fold if you’re of normal weight or slim.
  • Keep the needle in the skin for 5 seconds (10 seconds for a pen) after it’s fully depressed.
  • Place each injection at least one half-inch away from the previous one.
  • Rotate injection sites. You can use the abdomen (best absorption site), buttocks (slowest absorption site), and the front and side of your thighs, and upper and outer arms.

3. How do you care for the injection site?

Remember these tips to avoid pain and/or infection at your injection sites:

  • Start with clean hands before each injection.
  • Make sure your skin is dry before each injection.
  • You don’t need to swab your skin with alcohol before the injection if you bathe at least once a week and aren’t visibly dirty.
  • Use each needle only once.

4. Which complications should you watch for?

It’s normal to see some slight bleeding or bruising at the injection site. However, if this occurs consistently or you experience unusual pain with injections, your doctor can help you improve your technique.

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You shouldn’t have other complications if you follow our tips on caring for your injection site.

However, if you reuse needles or don’t rotate injection sites, you may experience lipohypertrophy. This inflammation or breakdown of fatty tissue creates lumps or thickens the skin. It can reduce insulin absorption and make it harder for you to manage your blood sugar.

5. How can you overcome fear of injections?

If fear is keeping you from starting injections or giving them to yourself regularly, these tips can ease you through the process:

  • Ask your doctor to schedule a visit with a diabetes educator. Diabetes educators are specially trained to teach people how to take insulin and will have more time to provide support as you learn.
  • Practice with dry injections first. This can make it easier when you’re first learning to take insulin.
  • Let the insulin reach room temperature before injecting it. This can make injections less painful.
  • Ask your doctor about changing your dosage if the volume of insulin in each injection is causing pain.
  • Ask your doctor if you might be able to use a port, which only requires a needle stick every two or three days.
  • Enlist the help of family members, caregivers or friends in giving you injections or reminding you to do so.

Taking insulin as your doctor prescribes will help keep your blood glucose on target. Talking to your doctor about your fears and concerns can help ease this process.

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Sue Cotey and Andrea Harris, RNs

Sue Cotey, RN, CDE, and Andrea Harris, RN, CDE, are Diabetes Educators with the Lennon Diabetes Center at the Stephanie Tubbs Jones Health Center. Sue is the Program Coordinator.