How To Use an Insulin Pen

In this video, we’ll show how to use an insulin pen.

Always check your blood sugar before using your insulin pen. Remember to start with clean, dry hands.

Once you know your blood sugar level, you can figure out whether it’s safe for you to take insulin and what dose you need. Your healthcare provider will teach you how to do these things. They’ll also tell you how long you can use the pen once you put a needle on it for the first time. Follow their instructions.

Once you know which insulin and what dose to take, set up your supplies on a clean, flat surface. You’ll need:

• Your insulin pen.
• A new, unused insulin pen needle.
• 2 alcohol wipes.
• A clean tissue.
• Your home sharps container, such as an empty laundry detergent bottle labeled “Home sharps—not for recycling.”
• A trash can.

Once you have your supplies, get your insulin pen ready.

Take the cap off the pen and set it down. Some types of insulin are meant to be clear, and others are meant to be cloudy. If you aren’t sure what your insulin should look like, ask your healthcare provider or pharmacist.

If your insulin is supposed to be clear, check to make sure it’s completely clear.  If it’s discolored or cloudy, don’t use it. Throw it away and get a new insulin pen.

If your insulin is supposed to be cloudy, mix it by gently rolling your insulin pen between your hands 10 times and tipping it up and down 10 times. The insulin should look evenly white and cloudy with no clumps or pieces floating in it. If you see any, keep mixing the insulin until you don’t.

Next, open an alcohol wipe and clean the rubber seal on the insulin pen. Throw the wipe away in the trash can.

Take the protective tab off the new insulin pen needle. Throw the tab away in the trash can.

Twist the needle onto the pen until it stops turning. Make sure to keep the needle straight as you twist it on. Once the needle is on the pen, take off the outer needle cap and set it to the side to use later. Take off the inner needle cap and throw it away in the trash can.

Next, prime your pen. This will help you make sure your pen and needle are working like they should, and that the needle fills with insulin so you get your full dose. It’s important to do this before every insulin injection. Injection is another word for shot.

Hold the pen so you can read the name of the insulin. Look at the dose window and turn the dose selector forward to dial it to 2 units. The arrow in the dose window should line up exactly with the number you need. It’s OK to turn it back if you go too far.

Hold your insulin pen so the needle is pointing up. Firmly press the injection button against the table or with your thumb. Look for drops of insulin coming out the tip of the needle.

If no insulin comes out, dial the dose selector to 2 units again. Press the injection button a second time. If insulin still doesn’t come out, dial the dose selector to 2 units again and press the injection button a third time.

If insulin still doesn’t come out, put the outer needle cap back on the needle. Twist the needle off the pen and drop it into your sharps container. Put a new needle on the pen and repeat the steps for priming it.

After you prime the pen, the dose selector should return to zero. If it doesn’t, turn the dose selector back until it does.

Dial the pen to your dose. Make sure the arrow is exactly lined up with the dose you’re injecting. If you can’t dial to the number of units you need, your insulin pen is probably almost empty. Get a new one so you can inject your full dose at once. Never inject less than a full dose or split your dose into 2 injections.

Once your pen is ready, choose an injection site. Don’t inject insulin into the same spot you used last time, or near incisions, scars, or stretch marks.  Each injection should be at least 2 inches (or 5 centimeters) from the last site you used. This helps prevent soreness and scar tissue. Following a pattern can help you remember to rotate injection sites.

For example, you can inject rapid-, or short-acting insulin, into your belly, at least 2 inches away from your belly button. You can inject long-acting insulin into the upper outer part of your thigh. Avoid injecting insulin into the front of your leg.

If you can’t use these areas, have someone give you the injection in the back part of your upper arm. Don’t try to inject into the back of your arm yourself. It’s too hard to reach the right area.

Using one of these areas will ensure that the insulin goes into the tissue just beneath your skin, and not into your muscles.

Once you’ve chosen your injection site, gently clean the skin with an alcohol wipe. To inject the insulin, hold your insulin pen in your fist with your thumb on the side of the pen. Gently pinch your skin at the injection site. In one smooth, quick motion, push the whole needle into your skin. Make sure it’s straight up and down, not tilted. 

Apply gentle pressure so you see a small dimple in your skin around the tip of the pen. Move your thumb to the top of the insulin pen. Hold the pen stable and push the injection button down firmly. Be careful not to press the pen harder into your body.

Once you press the button all the way down, keep holding it down and slowly count to 10. This gives the insulin time to come out of the pen. You should also see the numbers in the dose window go back to zero. After you count to 10, pull the needle straight out of your skin.

If you see a drop of blood at the injection site, press the area lightly with your finger or a tissue. Never rub the injection site after the injection. This can make the insulin work too fast.

Put the large outer needle cap back on the needle. Then, unscrew the needle from the insulin pen and drop it into your sharps container. Put the cap back on your insulin pen.

Store your insulin pen at room temperature, below 86 °F, or 30 °C. Keep it away from direct sunlight.

If you have any questions about using an insulin pen, talk with your healthcare provider.

For written instructions and more information about using insulin pens, such as how to store them and when to throw them away, visit www.mskcc.org/pe and search “insulin pen.”

For information about how to check your blood sugar, search “blood sugar level.”

For information about getting rid of your used lancets and pen needles, search “home medical sharps.”