Diabetes Month: The importance of good injection technique
November 25, 2022
For plan members, sponsors, and administrators
By Pav Ravi
Pavithra Ravi is a practicing pharmacist and teaches at the University of Waterloo School of Pharmacy. She is also Director, Strategy and Key Accounts, for Manulife Group Benefits.
November is Diabetes Month in Canada, so in this post, I’d like to talk about the importance of proper injection technique for people with diabetes, or people supporting a loved one who has diabetes.
Learning the proper injection technique is an important part of administering diabetes medication. Your health care team (doctor, nurse, pharmacist) can help explain, train, and demonstrate proper technique.
Why is technique so important?
Insulin is a growth hormone, so complications can arise if it’s not injected properly. And because diabetes patients might be injecting insulin multiple times a day, technique is very important. Here are some considerations to keep in mind:
Don’t force it: You might assume “more is better” when thinking about the amount of pressure to apply when injecting a medication, but the opposite is true. When injecting insulin, your skin shouldn’t dimple. This is a common error. A recent study found that over ¾ of the patients participating in the study applied too much force when injecting their insulin.1
Using too much force can result in the medication entering the muscle tissue instead of the skin fat, as intended. When medication is injected into muscle, it’s absorbed faster. This can lead to very low blood sugar, and swings of high to low blood sugar, both of which can be detrimental.
Rotate your injection sites: The spot where you inject is also important. We’re often creatures of habit and like to keep things consistent. But with injections, this can lead to negative results.
Injecting repeatedly in the same spot can cause trauma to the skin which leads to scar and fat tissue forming in that location (this is referred to as lipohypertrophy). The trauma can feel and/or look like a bump. This scar tissue can prevent medication from being absorbed properly and working as it should.
Talk to your health care professional about correct rotation of injection sites.
Don’t economise on needles: Insulin pen needles are intended for one-time use. If you reuse your pen needle you have an increased risk of developing lipohypertrophy.2
The length of your needle also plays a role. Depending on where you are injecting, a smaller needle usually is sufficient. Needles that are too long can end up in the muscle. Speak to your health care provider about the best choice and length of needle for you.
Lift with care and time it carefully: These two injection techniques should be discussed with your health care provider.
Skin lift (lifting the skin by using the thumb and index finger) isn’t usually required because it can lead to poor insulin absorption.
The length of time you leave the medication or pen in your skin is important. Poor technique can lead to medication leaks and poor absorption. Most medications state to leave the needle in the skin for a few seconds after the dose is administered. Ask your health care provider to confirm what’s right for you.
Life is busy and we all have many competing responsibilities. But taking care of yourself first will allow you to meet your other obligations more successfully. Take some time to remind yourself about these injection techniques periodically and try to correct any bad habits that might have formed. As this list shows, there are many benefits to be achieved:
- Proper injection technique has been shown to reduce your average blood sugar levels over the past 3 months (a1c) by 1%.3
- Proper injection technique can eliminate the risk of:
- Sugar swings
- Low blood sugar
- Bruising and bleeding
- Medication leakage, and
- Bumps (lipohypertrophy)
Read more: learn about blood glucose monitoring devices.
This article is published by the Manufacturers Life Insurance Company (Manulife) to provide information about current issues and assist in the decision‑making process. The article, however, is not intended to provide medical, financial, counselling, or legal advice and any queries you may have should be directed to an appropriate professional.
1. Bari, B., Corbeil, MA., Farooqui, H. et al. Insulin Injection Practices in a Population of Canadians with Diabetes: An Observational Study. Diabetes Ther 11, 2595–2609 (2020)
3. Misnikova IV, et al. Diabetes Ther. 2017;8(6):1309-1318