Getting started

• Gather your supplies. You will need an insulin syringe, your bottles of insulin, and an alcohol wipe or a cotton ball dipped in alcohol. Keep your supplies in a bag or kit so you can carry the supplies wherever you and your child go.
• Check the labels on the bottles and contents. Read and follow all instructions on the label, including how to store the insulin and how long the insulin will last.
• Wash your hands with soap and running water. Dry them well.

Preparing the shot

Sometimes you may give your child a single type of insulin. This is called a single-dose insulin shot. And sometimes you may mix two types of insulin in the syringe. This is called a mixed-dose insulin shot. Your doctor will tell you whether and when to use each type of shot.

To prepare a single-dose (Figure 1) insulin shot: (Figure 1)

1. Roll the bottle gently between your hands. This will warm the insulin if you have kept the bottle in the refrigerator. Roll a bottle of cloudy insulin between your hands until the white powder has dissolved.
2. Wipe the rubber lid of the insulin bottle with an alcohol wipe or a cotton ball dipped in alcohol. (If you are using a bottle for the first time, remove the protective cover over the rubber lid.) Let the top dry before you remove any insulin.
3. Remove the plastic cap from the needle on your insulin syringe. Take care not to touch the needle.
4. Pull the plunger of the syringe back, and draw air into the syringe equal to the number of units of insulin to be given.
5. Insert the needle of the syringe into the rubber lid of the insulin bottle. Push the plunger of the syringe to force the air into the bottle. This equalizes the pressure in the bottle when you remove the dose of insulin. Leave the needle in the bottle.
6. Turn the bottle and syringe upside down, and hold them in one hand. Position the tip of the needle so that it is below the surface of insulin in the bottle. Pull back the plunger to fill the syringe with slightly more than the correct number of units of insulin to be given.
7. Tap the outside (barrel) of the syringe so that trapped air bubbles move into the needle area. Push the air bubbles back into the bottle. Make sure you now have the correct number of units of insulin in your syringe.
8. Remove the needle from the bottle. Now you are ready to give your child the shot.

To prepare a mixed-dose (Figure 2) insulin shot (Figure 2):

1. Roll the cloudy insulin bottle (vial) gently between your hands. Roll the cloudy insulin bottle until all the white powder has dissolved. Rolling the bottle warms the insulin if you have been keeping the bottle in the refrigerator. Do not shake an insulin bottle.
2. Clean the lids of the bottles. If you are using a bottle for the first time, remove the protective cover from the rubber lid. If the rubber lid of the insulin bottle is dirty, clean it with an alcohol wipe or a cotton ball dipped in alcohol. Let the alcohol dry.
3. Draw air into the syringe for the cloudy insulin dose.
   1. Remove the plastic cap that covers the needle on your insulin syringe. Important: Do not touch the needle.
   2. Pull the plunger back on your insulin syringe and draw air into the syringe equal to the number of units of cloudy insulin to be given.
4. Force air into the cloudy insulin bottle.
   1. Push the needle of the syringe into the rubber lid of the cloudy insulin bottle.
   2. Push the plunger of the syringe to force the air into the bottle. This equalizes the pressure in the bottle when you later remove the dose of insulin.
   3. Remove the needle from the bottle.
5. Draw air into the syringe for the clear insulin dose. Pull the plunger of the syringe back and draw air into the syringe equal to the number of units of clear insulin to be given.
6. Force air into the clear insulin bottle.
   1. Push the needle of the syringe into the rubber lid of the clear insulin bottle. Note: You will draw the clear insulin into the syringe first, then the cloudy insulin (Step 8). It is important to follow this order.
   2. Push the plunger to force the air into the bottle. Leave the needle in place.
7. Draw clear insulin into the syringe.
   1. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle.
   2. Pull back the plunger to fill the syringe with slightly more than the correct number of units of clear insulin to be given.
   3. Tap the barrel of the syringe so that trapped air bubbles move into the needle area. Push the air bubbles back into the bottle. Important: Make sure that you have the correct number of units of insulin in your syringe.
   4. Remove the needle from the clear insulin bottle.
8. Insert the needle into the cloudy insulin bottle. Insert the needle into the rubber lid of the cloudy insulin bottle. Important: Do not push the plunger because this would force clear insulin into your cloudy insulin bottle. If clear insulin is mixed in the bottle of cloudy, it will alter the action of your other doses from that bottle.
9. Draw cloudy insulin into the syringe.
   1. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle.
   2. Slowly pull back the plunger of the syringe to fill the syringe with the correct number of units of cloudy insulin to be given. This will prevent air bubbles entering the syringe.
   3. Remove the needle from the bottle. You should now have the total number of units for the clear and cloudy insulin in your syringe. For example, if you need 10 units of clear and 15 units of cloudy, you should have 25 units in your syringe. Now you are ready to give the shot.

Giving your child the shot

1. Make sure the area of skin where you will give the shot is clean. If you use alcohol to clean your child's skin before you give the shot, let it dry.
2. Slightly pinch a fold of skin between your fingers and thumb of one hand.
3. Hold the syringe like a pencil close to the site, keeping your fingers off the plunger. It is usually recommended to place the syringe at a 90-degree angle to the shot site, standing straight up from the skin.
4. Bend your wrist, and quickly push the needle all the way into the pinched-up area.
5. Push the plunger of the syringe all the way in so the insulin goes into the fatty tissue.
6. Take the needle out at the same angle that you inserted it. If your child bleeds a little, apply pressure over the shot area with your finger, a cotton ball, or a piece of gauze. Do not rub the area.
7. Replace the cover over the needle, and dispose of the needle safely. Do not use the same needle more than one time.

Where to give the shot

You can inject insulin at a few places on the body (Figure 3). These places include:

• The belly, but at least 5 centimetres (2 inches) from the belly button. This is thought to be the best place to inject insulin.
• The top outer part of the thighs. Insulin usually is absorbed more slowly from this site, unless your child exercises soon after getting the shot.
• The outside of the upper arms or the buttocks.

Your doctor may advise you to give the shots in different places on your child's body each day. This is called site rotation. Make sure you talk to the doctor about how to do this safely. If you rotate sites, use the same site at the same time of each day. For example, each day:

• At breakfast, give the shot in one of your child's arms.
• At lunch, give the shot in one of your child's legs.
• At dinner, give the shot in your child's belly.

Slightly change the spot where you give an insulin shot each time you do it. For example, use five different places on the right upper arm, then use five places on the left upper arm. Using the same spot every time can cause bumps or pits in the skin and make the shots hurt more. It may also slow down how the insulin is absorbed into your child's body.

Figure 1 - How to prepare a single dose of insulin

Follow these steps when preparing an insulin shot with one type of insulin.

Roll the bottle gently.

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slide 1 of 7, Roll the bottle gently.,

Roll the insulin bottle (vial) gently between your hands. Roll a bottle of cloudy insulin until the white powder has dissolved.

Rolling the bottle will warm the insulin if you have been keeping the bottle in the refrigerator.

Important: Do not shake an insulin bottle.

Clean the lid of the bottle.

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slide 2 of 7, Clean the lid of the bottle.,

1. If you are using a bottle for the first time, remove the protective cover from the rubber lid.

2. If the rubber lid of the insulin bottle is dirty, clean it with an alcohol wipe or a cotton ball dipped in alcohol. Let the alcohol dry.

Remove the needle cap.

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slide 3 of 7, Remove the needle cap.,

Remove the plastic cap covering the needle on your insulin syringe.

Important: Do not touch the needle.

Draw air into the syringe.

slide 4 of 7

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slide 4 of 7, Draw air into the syringe.,

Pull the plunger of the syringe back and draw air into the syringe equal to the number of units of insulin to be given.

Force air into the bottle.

slide 5 of 7

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slide 5 of 7, Force air into the bottle.,

1. Insert the needle of the syringe into the rubber lid of the insulin bottle.

2. Push the plunger of the syringe to force the air into the bottle. This equalizes the pressure in the bottle when you later remove the dose of insulin.

3. Leave the needle in the bottle.

Draw insulin into the syringe.

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slide 6 of 7, Draw insulin into the syringe.,

1. Turn the bottle and syringe upside down.

2. Position the tip of the needle so that it is below the surface of insulin in the bottle.

3. Pull back the plunger to fill the syringe with slightly more than the correct number of units of insulin to be given.

Remove the air bubbles.

slide 7 of 7

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slide 7 of 7, Remove the air bubbles.,

1. Tap the barrel of the syringe so that trapped air bubbles move into the needle area.

2. Push the air bubbles back into the bottle. Important: Make sure you have the correct number of units of insulin in your syringe.

3. Remove the needle from the bottle. Now you are ready to give the shot.

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Figure 2 - How to prepare a mixed dose of insulin

You will mix insulin from two bottles (vials). The order in which you mix the cloudy (long-acting) and clear (short or rapid-acting) insulin is important. Follow the order of the steps below.

Roll the cloudy insulin bottle gently between your hands.

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slide 1 of 9, Roll the cloudy insulin bottle gently between your hands.,

Roll the cloudy insulin bottle until all the white powder has dissolved.

Rolling the bottle warms the insulin if you have been keeping the bottle in the refrigerator.

Do not shake an insulin bottle.

Clean the lids of the bottles.

slide 2 of 9

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slide 2 of 9, Clean the lids of the bottles.,

If you are using a bottle for the first time, remove the protective cover from the rubber lid.

If the rubber lid of the insulin bottle is dirty, clean it with an alcohol wipe or a cotton ball dipped in alcohol. Let the alcohol dry.

Draw air into the syringe for the cloudy insulin dose.

slide 3 of 9

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slide 3 of 9, Draw air into the syringe for the cloudy insulin dose.,

1. Remove the plastic cap that covers the needle on your insulin syringe. Important: Do not touch the needle.

2. Pull the plunger back on your insulin syringe and draw air into the syringe equal to the number of units of cloudy insulin to be given.

Force air into the cloudy insulin bottle.

slide 4 of 9

< PrevNext >

slide 4 of 9, Force air into the cloudy insulin bottle.,

1. Push the needle of the syringe into the rubber lid of the cloudy insulin bottle.

2. Push the plunger of the syringe to force the air into the bottle. This equalizes the pressure in the bottle when you later remove the dose of insulin.

3. Remove the needle from the bottle.

Draw air into the syringe for the clear insulin dose.

slide 5 of 9

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slide 5 of 9, Draw air into the syringe for the clear insulin dose.,

Pull the plunger of the syringe back and draw air into the syringe equal to the number of units of clear insulin to be given.

Force air into the clear insulin bottle.

slide 6 of 9

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slide 6 of 9, Force air into the clear insulin bottle.,

1. Push the needle of the syringe into the rubber lid of the clear insulin bottle. Note: You will draw the clear insulin into the syringe first, then the cloudy insulin (Step 8). It is important to follow this order.

2. Push the plunger to force the air into the bottle. Leave the needle in place.

Draw clear insulin into the syringe.

slide 7 of 9

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slide 7 of 9, Draw clear insulin into the syringe.,

1. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle.

2. Pull back the plunger to fill the syringe with slightly more than the correct number of units of clear insulin to be given.

3. Tap the barrel of the syringe so that trapped air bubbles move into the needle area. Push the air bubbles back into the bottle. Important: Make sure that you have the correct number of units of insulin in your syringe.

4. Remove the needle from the clear insulin bottle.

Insert the needle into the cloudy insulin bottle.

slide 8 of 9

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slide 8 of 9, Insert the needle into the cloudy insulin bottle.,

Insert the needle into the rubber lid of the cloudy insulin bottle.

Important: Do not push the plunger because this would force clear insulin into your cloudy insulin bottle. If clear insulin is mixed in the bottle of cloudy, it will alter the action of your other doses from that bottle.

Draw cloudy insulin into the syringe.

slide 9 of 9

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slide 9 of 9, Draw cloudy insulin into the syringe.,

1. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle.

2. Slowly pull back the plunger of the syringe to fill the syringe with the correct number of units of cloudy insulin to be given. This will prevent air bubbles entering the syringe.

3. Remove the needle from the bottle. You should now have the total number of units for the clear and cloudy insulin in your syringe. For example, if you need 10 units of clear and 15 units of cloudy, you should have 25 units in your syringe. Now you are ready to give the shot.

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Figure 3 - Insulin injection areas

There are several areas of the body where insulin may be injected:

• The belly, at least 5 cm (2 in.) from the belly button. The belly is the best place to inject insulin. This is because the belly area can absorb insulin most consistently.
• The front of the thighs. Insulin usually is absorbed more slowly from this site. It may go more quickly here if you exercise soon after injecting insulin.
• The back of the upper arms.
• The upper buttocks.

Rotate the location of the injection. And at each location, slightly change the injection spot each time you inject insulin. Avoid injecting in the exact same spot. Using the same spot every time can form bumps or pits in the skin. For example, inject your insulin in your left upper arm, then the next time in your upper thigh, then the next time in your left upper arm again but slightly lower than before.

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.