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First, you must have the vile of insulin and a clean, sterile syringe that has not been used yet. Put the needle of the syringe in the hole of the insulin vile, and turn it upside down. Then, pull down on the moveable part of the syringe to the amount you want in the syringe. Then, take the syringe out of the vile, and set the vile down. Next, wipe the spot where you are going to inject the insulin into with an unused alcohol swab. Then, put the needle into the spot where you want to inject yourself, and then inject the insulin into your body. Then, take the needle back out of your body, and you have just injected insulin.

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And before drawing insulin (or any other injection) you should wipe the top of the vial (the rubber part) thoroughly with a fresh alcohol swab. Use two things - TIME and FRICTION to try to remove as much bacteria from the stopper as you can. Do not touch the top with your finger - only the alcohol swab. This will help prevent your needle (sterile) from contaminating the contents of the bottle by picking up bacteria from the rubber stopper as you insert it through the stopper - and it will save contaminating you when you inject yourself!

Don't forget to first inject the amount of air equivalent to the dose of insulin you will be withdrawing from the vial. If you are administering insulin per a sliding scale, calculate the dosage according to your pre-meal blood glucose reading using the sliding scale recommended by your health care professional. If you are administering a basal dose of a intermediate acting insulin like insulin isophane (NPH), or the very-long-acting insulins such as insulin detemir (Levemir) or insulin glargine (Lantus), follow the dosage your health care provider has recommended. Remember that you MUST use an INSULIN syringe only, as they are calibrated in "UNITS" not milliliters.

NPH insulin (the cloudy insulin) can be mixed with other types of insulins EXCEPT FOR detemir and glargine. Insulin detemir (Levemir) and insulin glargine (Lantus) SHOULD NOT be mixed in the same syringe with ANY other drug or insulin.

To mix two insulins, such as insulin aspart (Novolog) and insulin isophane (NPH) remember you must draw up the clear insulin first. So first, you roll the bottle of NPH (the CLOUDY insulin) to mix it. DO NOT SHAKE as this will instill air bubbles in the insulin! Then you fill the needle with the amount of air that is equal to the dose NPH (the CLOUDY insulin), and JUST INJECT THE AIR into the NPH vial (DO NOT draw the insulin at this time). Remove the needle, draw up the amount of air equal to the dose of the Novolog, and inject it into the vial of Novolog, then draw that amount of Novolog into the syringe. Now, REINSERT the needle into the NPH vial, (no need to inject any more air, we already did that!) and withdraw the dose of NPH. When finished, you should have ONE dose equivalent to the sum of both insulin doses. So for example, you have a basal dose of 5 units of NPH, and your sliding scale says at your blood glucose reading of 180, you should take 2 units (JUST AN EXAMPLE - *ALWAYS* follow the sliding scale given to you by YOUR health care provider!), then you would clean the top of the NPH vial with a swab, inject 5 units of air, then with a clean swab, clean the Novolog, inject 2 units of air, turn it over, careful to support the bottle so the needle does not bend, and draw 2 units of Novolog into the syringe. With the needle still in the vial, gently flick the needle if any air bubbles remain, until you have nothing but insulin in the syringe. The air won't hurt you, but it will displace the insulin, making the dose less than it should be. Then go back to the vial of NPH and withdraw the 5 units, for a total of 7 units in the syringe. You may wish to draw a tiny bit more NPH, and then flick the syringe to removed trapped air after removing it from the bottle. Gently squirt the tiny bit of extra insulin and air until you are at the 7 unit mark. Then you would be ready to inject the total at the chosen site, after cleaning the skin with another alcohol swab.

There are also now insulin "pens" on the market now, with screw on tips that contain a shielded needle to prevent sticks, and some even have an indicator that shows when the dose was injected properly. However, these tend to be more expensive due to the cost of the needle tips in addition to the cost of the pen (insulin) itself. For use of the pens, it is best to consult a health care professional, pharmacist, or Diabetes educator.

ALWAYS check your insulin for expiration date - do not use insulin that is past date, as it may not work as expected.

It is always best to seek advice from a health care professional or diabetes educator before beginning insulin injections for the first time. They can help with training and personalized advice to help take some of the pain out of taking your insulin shots.

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Q: How do you inject insulin?
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Lypo dystropy


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