Insulin injection technique best practicesExpert recommendations on injecting insulin with pen and insulin syringe needles If you inject diabetes medication, you should know how important correct injection technique is for effectively managing your diabetes. Your pen needle or insulin syringe, type of medication and rotation of injection sites all play critical roles, which can lead to better treatment results.1

Hold for 10 seconds after injectionKeeping the plunger button pushed down for 10 seconds‡ before removing the needle from your skin helps ensure that the full dose is delivered and minimizes dripping or leaking. Don’t worry if a small droplet of liquid appears on the skin after injection; in most cases, this is clinically insignificant to your dose.2

Ask your doctor or pharmacist for a 4 mm pen needle injection technique worksheet.* Follow the manufacturer’s instructions.† Children from 2 to 6 years old, extremely lean adults or patients with loose skin may need to use a pinch-up technique.‡ It may take more or less than 10 seconds; for large doses, counting beyond 10 seconds may be necessary to avoid dripping or leaking. Through trial and error, you can find the hold time that’s right for you.

10 tips for injecting with a pen needle

Use the shortest needleInsulin delivery recommendations published in Mayo Clinic Proceedings state that all types of patients should inject with the shortest needle—such as a 4 mm pen needle. Always inject into the healthy subcutaneous (SC) tissue, avoiding any scars, lumps, inflammation or infection.2

SC tissue

Skin layer

Muscle layer

1

6

2

7

3

8

4

9

5

10

Attach the pen needle straight onto the penMake sure your pen needle is lined up straight with your pen, and twist until it is tight to ensure proper connectivity.

Mix cloudy insulin and prime your penIf you use cloudy (NPH or premixed) insulin, gently roll and tip the pen until the insulin becomes milk white. Before injecting, prime your pen* to make sure there’s a free flow of insulin.2

Injection sites should be clean and dryIf the injection site is not clean, clean the skinand wait for it to dry completely before injecting.2

Check your techniqueIf you’re using a 4 mm or 5 mm pen needle, you can inject at 90° without using a pinch-up technique.† A 4 mm needle is long enough to pass through the skin and enter the SC tissue layer with little risk of intramuscular injection.2,3

Properly dispose of your used pen needlesAlways dispose of used pen needles immediately after injection into a proper medical sharps container.2

Always inject with a new needlePen needles are designed for single use and should only be used once—they are no longer sterile after use.2

Rotate your injection sitesFollow a plan to rotate between and within all areas (abdomen, thighs, upper arms, buttocks), always moving one finger width away from your last injection site.2

Avoid injecting into lipohypertrophy (lipo)Unhealthy lumps and bumps called lipo can form under the skin of people who inject insulin. If you inject into them, your insulin may not work properly. You should always inject into healthy skin.2

SC tissue

Skin layer

Muscle layer

10 tips for injecting with an insulin syringe

Use the shortest needleInsulin delivery recommendations published in Mayo Clinic Proceedings state that all types of patients should inject with the shortest needle—such as a 6 mm insulin syringe needle.* Always inject into the healthy subcutaneous (SC) tissue, avoiding any scars, lumps, inflammation or infection.2

You don’t need to hold for 10 secondsUnlike injections with pen needles, insulin syringe users don’t need to hold the needle in the skin for 10 seconds after injection before removing it.2

Ask your doctor or pharmacist for a 6 mm insulin syringe needle injection technique worksheet.

Clean the top of the insulin vialBefore drawing up your dose of insulin, use an alcohol swab to disinfect the rubber seal.

Mix cloudy insulinIf you use cloudy (NPH or premixed) insulin, gently roll and tip the vial until the insulin becomes milk white.2

Injection sites should be clean and dryIf the injection site is not clean, clean the skinand wait for it to dry completely before injecting.2

Inject using a pinch-up techniqueIf you’re using a 6 mm or longer insulin syringe needle, you can inject at 90° using a pinch-up technique.2

Properly dispose of your used insulin syringe needlesAlways dispose of used insulin syringes immediately after injection into a proper medical sharps container.2

Always inject with a new needleInsulin syringes are designed for single use and should only be used once—they are no longer sterile after use.2

Rotate your injection sitesFollow a plan to rotate between and within all areas (abdomen, thighs, upper arms, buttocks), always moving one finger width away from your last injection site.2

Avoid injecting into lipohypertrophy (lipo)Unhealthy lumps and bumps called lipo can form under the skin of people who inject insulin. If you inject into them, your insulin may not work properly. You should always inject into healthy skin.2

* Excluding syringes used in hospital settings.

1

2

3

4

5

6

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Normal vs. enlargedadipocytes (fat cells)

Lipo visible on inspection Lipo on left identi�edby shiny skin surface

Adipocytes (fat cells) in�ltrate the dermis (skin)

Use �rm downward pressure pushing deep into fat layer

A

B

100 µ

100 µ 1 mm

You can usually feel the edge of the lipo as a harder ridge

Lipoatrophy visibleon inspection

10

BD Nano™ 4mm Pen Needles Our shortest pen needle—in line with the latest injection technique recommendations from diabetes experts2

BD pen needles and insulin syringes are covered by most health plans at the preferred co-pay, including Medicare Part D.*

* Co-pays and preferred status vary by plan.

• The shortest BD pen needle for easier, one-handed injections at more sites3

• Exclusive PentaPoint™ Comfort creates a thinner and flatter needle tip for an easier and more comfortable injection4

• EasyFlow™ Technology allows insulin to flow more freely through the needle and does not require you to push the button on your pen as hard to deliver your injection5

• Compatible with leading diabetes medication pens6

BD Insulin Syringes with BD Ultra-Fine™ 6mm Needles Our shortest insulin syringe needle— in line with the latest injection technique recommendations from diabetes experts2*

• The shortest BD insulin syringe needle for safer injections3 • A shorter and thinner-gauge needle designed for more

comfortable injections†

• Available in a range of syringe barrel sizes (or capacities), with large dose unit markings designed to be easier to read when drawing insulin to the correct dose

• Available with a half-unit scale for small doses—ideal for pediatric patients and those with insulin sensitivity

* Excluding syringes used in hospital settings.† Compared to longer insulin syringe needles.

References: 1. Frid AH, Hirsch LJ, Menchior AR, Morel DR, Strauss KW. Worldwide injection technique questionnaire study: injecting complications and the role of the professional. Mayo Clin Proc. 2016;91(9):1224-1230. 2. Frid AH, Kreugel G, Grassi G, et al. New insulin delivery recommendations. Mayo Clin Proc. 2016;91(9):1231-1255. 3. Gibney MA, Arce CH, Byron KJ, Hirsch LJ. Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections: implications for needle length recommendations. Curr Med Res Opin. 2010;26(6):1519-1530. 4. Hirsch L, Gibney M, Berube J, Manocchio J. Impact of a modified needle tip geometry on penetration force as well as acceptability, preference, and perceived pain in subjects with diabetes. J Diabetes Sci Technol. 2012;6(2):328-335. 5. Aronson R, Gibney MA, Oza K, Bérubé J, Kassler-Taub K, Hirsch L. Insulin pen needles: effects of extra-thin wall needle technology on preference, confidence, and other patient ratings. Clin Ther. 2013;35(7):923-933. 6. BD Pen Needle Compatibility Status Summary with Diabetes Care & Non-Diabetes Drug Delivery Devices; Documents Number: 149OTH-0004-02 Dated: April 2016; 10000308903 Ver A Dated: 30 March 2017.

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