I am Christel from Diabetes Strong in this video I'm going to show you
how to inject insulin. So it's going to be very practical.
I'm going to show you different injection techniques,
depending on the length of the needle that you choose.
But before we do that, let's just talk
a little bit about insulin. Insulin is a hormone that everyone needs to stay alive.
It helps transport the energy that you consume, so everything you eat or drink,
into energy in the body. It transports it from the bloodstream into
your liver, into your fat, and into your skeletal muscle cells.
If you live with diabetes and you have little to no insulin
production left, you will need to inject insulin and you will have to do that daily.
I've been living with type 1 diabetes since 1997, and have had to manage my blood
sugars with insulin injections since the day of my diagnosis.
There's no cure for diabetes, so we have to manage with insulin
and I've found that with the right technique, I'm going to show you the technique
and the right length of needle, I'll link to that up here,
insulin injections do not have to be painful,
and they can be something that becomes a routine,
and something that doesn't stand in the way of you living your life.
Now I'm going to show you how to do an injection using a shorter needle,
so that's a 4-5 millimeter
needle. I'm gonna be using this pen needle, that is 4 millimeters, I'll show you the box,
looks like this. These are the ones I usually use.
So what you need is, you'll need your insulin pen,
this is a pre-filled pen, meaning the insulin is already in here,
same deal for durable pens.
But you need your pen, you need a needle, and you need an alcohol swab.
So first things first, is you want to clean your skin. Since this is a shorter needle
I can do it one-handed, so I'm going to show you the injection on my arm.
So here we go, I'm going to clean the skin first okay,
and let that dry while I prep the pen.
You want to get your pen, you want to get your needle.
Okay so take off the cap of your insulin pen.
So right now there's no way of injecting this insulin because there's no needle on it. So
when you take your needle, pull off the outer cap,
that's not really cap, the protection shield here.
Okay so that is off and now you can screw this pen needle onto the pen.
So simply just screw it on.
There you are, so now you want to remove the outer cap,
see there's an inner cap on there, so
I can't poke myself, yet, so still be careful
right. So once you take off the inner cap, here you go, you can see the needle.
You see it's tiny, it's only 4 millimeters long.
Next step is you want to do an air shot.
We do that to make sure the insulin is flowing and that you're not,
well, injecting air. So
you want to dial up to two, hear that, one, two.
You can also see it in the little window here.
You might want to, some people, do less than two, two is the recommended.
So you want to do a few clicks, to get any air bubbles up to the top,
so that we can get those out of the pen. See it here
That's what an air shot looks like. Usually, I do it into a napkin, now
to clean up. Next step is you want to dial up to how many units you need, say that I need
four. I'm not actually going to inject this because I don't need four units right, now
but I'm going to show you because this doesn't hurt.
So we cleaned the skin, again this is a shorter needle,
so we can get away with a 90-degree angle.
So that means simply the needle goes directly in,
you don't need to do a skin fold, again because it's a shorter needle.
So what you want to do is choose the place on your body, it doesn't have to be the arm,
I'll walk you through which placements are good later on in this video.
But you simply hold it up against the skin, and then, I need to look, there you go.
See right now, you saw that didn't hurt. I just pushed in the needle,
I'm holding in the needle right now at a 90-degree angle.
So then you simply push the plunger, you don't have to push the pen into the arm,
you only want to push the plunger, push that all the way in. Just imagine that I
pushed it in. Okay then you want to hold it like this for another five to ten seconds,
so you simply count one and two and three four and five.
The reason why we do this is to make sure
that there is no leakage, meaning that the insulin actually stays in the tissue
rather than just come flowing out. Okay, so we're actually done with the injection now.
So next the needle is still on, so we want to get that off,
so be careful that you don't poke yourself on the needle.
There are several ways of disposing of the needle. You can screw it off,
and put it in a sharps container or you can use something like a BD needle cutter. This
is like a tiny sharp container. What you do is that you simply put the needle in,
click and you just cut off the needle. Then you just screw it off
there you go, put back the cap
and store it until the next time you need to take an insulin injection.
And that's how you do a one-handed injection,
with a 90-degree angle, using a shorter needle.
Now I'll show you how to do an insulin injection using a longer needle,
so that's any needle 6 millimeters or longer.
I'll be using this syringe, see the box here, this one is 8 millimeters long.
Given it has the length that it has, it's a longer needle,
I can't do a one-handed 90-degree angle,
we will have to do a skin fold or a 45-degree angle.
So instead of 90, then a 45-degree angle.
I'm going to do both and I'm going to show you how to do that on the stomach.
Just mean I have to move around a little bit here.
To do an insulin injection using a syringe, you'll need
your syringe, you'll need a vial of insulin, and you'll need an alcohol swab.
The alcohol swap is for cleaning the skin,
so that's what you want to start doing. So clean the place on the skin where
you want to inject it. Given it's a longer needle,
remember you need to be able to use two hands,
and this is regardless of whether or not it's a syringe or a pre-filled pen,
where you screw on a needle. Okay so first things, first let me show you the syringe.
You take off the end here, it exposes a plunger, don't push it.
Next thing you want to take off the protection cap
now the needle is exposed so be careful that you don't poke yourself on it.
So I don't have a vial of insulin, because I use pre-filled pens, so you have to imagine
a vial of insulin. So what you want to do is, you want to put the needle,
so I only the needle part, into the vial, through the little rubber seal. Okay,
and you want to then flip it upside down, so I'm holding the syringe here
okay. So what you want to do now, is that you want to, let me just hold this right.
So you're holding it like this, right,
so what you want to do is you want to push a little bit of air into the vial,
okay. We do that because it makes it easier to pull out the insulin.
So you push that in, okay so now a little bit of air is gonna rise to the top of our vial,
and then you can pull out how many ever units you need.
See I'm pulling with these fingers down here that pulls down the plunger
and see now I have the equivalent of five units in my syringe.
It's a little hard to see, but
there are indications of how many are there and I'm now ready to do the injection.
So let me just show you and I'm going to show you on my belly,
so I'm going to stand up. I'm going to cut my head off, but that's okay.
So imagine I already used the alcohol swab to clean the skin,
so this is clean, then I want to pinch a little bit of skin here.
You don't want to take too much, as you don't want to get the muscle,
but you want to pinch the skin a little bit and then
you don't want to go straight in with the needle. You want to go in an angle,
okay, 45-degree angle, and if it's not exactly 45, that'll be fine.
But you can see it here, you ready, and I simply just push the needle in.
See now the needle is in the skin, a little hard to see the 45-degree angle,
but it's not like that, it's a little tilted, right, and then you simply push the plunger,
all the way down. I'm not going to push it down, because there's air in here,
but assuming there's insulin, you simply push the plunger all the way down.
Once it's all the way down, the insulin dose has been delivered.
However, we still want to hold it in for five to ten seconds longer,
so we do a one and two and three, four, five, six, seven, eight, nine, and ten.
Reason for this is to make sure there's no leakage.
You can also pull the needle halfway out, so now it's halfway out, so now it's halfway out
and you can do the count. Okay, once you're done, pull out completely,
no blood no nothing and the insulin injection is done.
Now however you have a syringe with a needle on it, so you need to dispose of that,
and it should not go into the trash, it shouldn't go into the recycle.
So you can either put it in a store-bought, or a homemade, sharps container,
or you can use this, it's a BD needle cutter, and it's basically a tiny sharps container.
It has a little hole up here, simply put in your needle, press it,
voila the needle is gone and you can now dispose of this in the trash.
And that is how you do at 45-degree angled,
skinfold, injection using a longer needle.
There are few things to keep in mind when it comes to insulin injections.
First is that the insulin should be injected into the fatty tissue
right beneath your skin. So think about it like this; there's the skin, there's fatty tissue,
and then there's muscle. The insulin should go into the fatty tissue,
and that's if you use the right injection technique, is where it should end up.
If you inject directly into the muscle instead, for example, if you pinch too much
of the skin, or if you don't use an angled injection technique with
a longer needle, you might inject into the muscle tissue. If you do that there is a risk
of the insulin being absorbed faster which potentially can lead to a low blood sugar.
There are a few places where you can inject insulin,
so let me just show you a visual here. I kind of like that one.
So the place that most people use is the belly area. You can use that,
just stay clear of the belly button, around two inches around it.
Other good places, in my opinion, is the back of your arms,
I really like that position, if you use a shorter needle you can
do that because you don't have to pinch the skin.
There's also lower back and glutes, thighs, so as
you can see there are plenty of places to choose from
so that you can rotate your injection sites.
Let's finish up with a few tips on insulin injections. First one is;
choose a needle that's right for you. So I linked a video before (can't link to that
again, on needle sizes) and that's both for pen needles and syringes. But just know,
that for most people using a shorter needle will be ideal.
Second, remember insulin doesn't start to work right away.
So if you use a mealtime insulin like a Novolog or Humalog,
remember that once you inject the insulin it actually takes it up to 15 minutes or more,
for it to hit your bloodstream. That means it doesn't start to work in your body until
15 minutes after it's injected, and it doesn't peak, meaning it's not at its most intense,
let's say that, until an hour after you injected it.
And finally, it will stay in your body for three to five hours,
so if you're having a low blood sugar, let's say four hours after you injected
your mealtime insulin, it might have been too high of a dose.
And finally, rotate your insulin injection sites.
We do that to preserve good insulin absorption
as well as to reduce the risk of developing lumps.
I'll leave a video on how to do that up here.
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