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Insulin Pens: How to Give a Shot

The following instructions are for using most disposable insulin pens. If you are using a refillable pen, check with your doctor, diabetes educator or pharmacist on how to use. 
ADVANTAGES of insulin pens:
Easy to use and carry
Looks like a pen for writing (discreet/not easily noticed)
No need to draw the insulin dose from a vial/bottle 
Can be used for most insulin types 
Doses can be easily dialed 
Less waste of expired insulin if not much insulin is used within time period designated (300 units in each pen)…see table end of this document 
To some people it may be less scary than a syringe
Cannot mix different kinds of insulin together in a prescribed dose.
What You Will Need
Before you give the shot, you will need the following:
Insulin pen 
Alcohol swab, or cotton ball moistened with alcohol 
Pen needle (be sure your doctor writes your prescription for the pen needles as well as the specific type of insulin pen)
Hard plastic or metal container with a screw-on or tightly-secured lid
Parts of an Insulin Pen
Drawing of the parts of an insulin pen
How to Use
Wash your hands.
Check the drug label to be sure it is what your doctor prescribed. Check the expiration date on the pen. Do not use a drug that is past the expiration date. Also do not use if beyond number of days listed in table at end of this document once opened and in use. 
Remove pen cap.
Look at the insulin.
Short or rapid-acting insulin (Regular, Humalog, NovoLog, and Apidra) and Lantus or Levemir should appear clear. Do not use it if the drug appears to have pieces in it or is discolored.
Intermediate or mixed insulin (NPH, 75/25, 70/30, or 50/50) will appear cloudy and white. This type of insulin should be gently mixed before use. To do this, roll the pen between your hands. You must also turn the pen up and down ten times as shown in picture 
Look at the insulin to be sure it is evenly mixed (cloudy white) with no clumping of particles.
Wipe the tip of the pen where the needle will attach with an alcohol swab or a cotton ball moistened with alcohol. 
Remove the protective pull tab form the needle and screw it onto the pen until snug (but not too tight).
Remove both the plastic outer cap and inner needle cap.
Look at the dose window and turn the dosage knob to ‘2’ units.
Holding the pen with the needle pointing upwards, press the button until at least a drop of insulin appears. This is the ‘air shot’ or safety shot. Repeat this step if needed until a drop appears 
Dial the number of units you need to take. 
Decide where on your body you will give the shot. Be sure to give the shot in a different place each time. You can stay in the same general area. Try to stay at least 1 inch from the last shot, any scars, and your belly button. Keep a diary to remember where your last shot was given.
To hold the pen, wrap your fingers around the pen with your thumb free to reach the dosing knob.
With the other hand, gently pinch up the skin around where you will give the shot and hold firmly (‘pinching’ is most important when you are injecting in an area that does not have a lot of fat). You may not need to pinch if giving into a fatty area like the abdomen or if you are using a short needle .
Insert the needle at a 45 to 90 degree angle. Ask your doctor or nurse which angle is best for you (longer needles may require 45 degree angle, where shorter needles may be given straight at a 90 degree angle). 
While keeping needle under skin, press the button all the way returning to zero, and keep pressing for six to ten seconds (larger doses may require the whole ten seconds). Withdraw from the skin.
If you bleed when the needle comes out, place an alcohol swab over the skin right away. Press gently on the swab until bleeding has stopped. Do not rub the skin. 
Carefully replace outer needle cap over needle and unscrew until loosened (needle should come off pen inside needle cap). Never leave needle on pen when not in use.
Throw away the needle in a hard plastic or metal container. Close the lid tightly. When the container is full, tape the lid down, and throw it away in the garbage, (but not with recyclables). Note: Check your town’s guidelines on syringe disposal.
Insulin Storage
Do not freeze insulin. Do not store insulin in sunlight or in a hot car. Take insulin onboard with you when traveling by airplane. Do not put insulin into luggage that will be stored.