If you have been talking about getting started on insulin with your doctor, or if taking insulin is new to you, you may have questions or concerns.

The following guide will help you understand the types of insulin, options for taking insulin, how and where to inject insulin, and insulin care and storage.

Insulin pens

Your pen comes with an instruction book. Please review it to understand how your pen works, how to load the cartridge and how to prepare your pen for an insulin injection. There are different sizes and lengths of needle tips available. Most often the shortest needle is recommended. Talk with your health-care professional about which needle tip would be best for you.

Mixing insulin

Insulin that is cloudy (NPH, premixed) needs to be mixed before using. The pen should be rolled ten times, tipped ten times and checked for a milky-white consistency.

Check insulin flow (prime)

Attach pen needle. Dial up two or three units (whichever the manufacturers recommend) and, with pen tip facing upwards, push the dosing button. If no stream of insulin appears, repeat this step again.

Giving your injection

After you have checked the insulin flow, dial up the dose of insulin to be taken. Insert pen tip into skin at a 90º angle. Push the dosing button until you see ‘0’. Count 10 seconds before removing the needle from your skin to ensure you receive the full dose. With longer needles (≥ 8mm), you may need to gently lift the skin before injection.

Insulin Injections area

Insulin injection sites
Site Things to think about

Abdomen (tummy)

  • Stay 2 inches (5 cm) away from your belly button
Easy to reach. Insulin absorbs fast and consistently.
Buttock and thigh Slower absorption rate than from abdomen and arm sites.
Outer arm After abdomen, arm provides the next fastest absorption rate. This area is hard to reach when injecting yourself, so it is often not recommended.

NOTE: It is really important to change (rotate) where you give yourself insulin to prevent fatty lumps from forming since these can affect how your body absorbs insulin. For example, you can move from one side of your abdomen to the other side, and you can also move your injection site to a different location within each side of your abdomen.

Avoid a two-inch area around the belly button as well as scar tissue.

Insulin types

Type
Onset
(How quickly it starts working)
Onset
(When it is most effective)
Duration
(How long it works)
Timing of injection
(When should it be given)
Bolus insulins
Rapid acting analogues
  • Apidra/ Humalog/ NovoRapid

10-15 min

1-2 hrs

3-5 hrs

Given with 1 or more meals per day. Should be injected 0-15 minutes before or after meals. Fiasp is to be given 2 minutes before the start of your meal or within 20 minutes after.
  • Fiasp
4 min 30 min - 1.5 hrs 3-5 hrs
Short-acting

  • Entuzity

15 min

4-8 hrs

17-24 hrs

Given with one or more meals per day. Should be injected 30-45 minutes before the start of the meal.
  • Humulin-R/ Novolin ge Toronto
30 min 2-3 hrs 6.5 hrs
Basal insulins
Intermediate-acting
  • Humulin-N/ Novolin ge NPH

1-3 hrs

5-8 hrs

Up to 18 hours

Often started once daily at bedtime. May be given once or twice daily. Not given at any time specific to meals.
Long-acting
  • Basaglar/ Lantus

90 min

Not appli- cable

Up to 24 hrs

Often started once daily at bedtime. Insulin detemir (Levemir) may be given once or twice daily. Not given at any time specific to meals.
  • Levemir

16-24 hrs

  • Toujeo

> 30 hrs

  • Tresiba

42 hrs

Premixed insulins
Premixed regular insulin
  • Humulin 30/70
  • Novolin ge 30/70, 40/60, 50/50
The onset, peak, and duration of premixed insulins depend on the amounts of rapid-acting or short-acting insulin and intermediate-acting insulin. See above for more information based on the specific insulins contained in the premixed insulin.  Given with one or more meals per day. Should be injected 30-45 minutes before the start of the meal.
Premixed insulin analogues
  • Humalog Mix 25, Mix 50/ NovoMix 30
Given with one or more meals per day. Should be injected 0-15 minutes before or after meals.

Insulin care and storage

Unopened insulin should be stored in the fridge between 2ºC and 8ºC. Opened insulin can be stored at room temperature for up to one month. Both Levemir and Toujeo are the exception; they are safe at room temperature for 42 days. Keep all insulins away from direct heat and light. Discard insulin that has been frozen, exposed to temperatures greater than 30ºC, or expired. 

Diabetes identification

You should always wear idenfication, such as a bracelet or necklace, to identify that you have diabetes. Identification bracelets, such as MedicAlert®, can be purchased at pharmacies and jewellery stores. Always carry identification in your wallet or purse that provides information about your diabetes.

Checking your blood sugars

Below is a schedule you can use to help you organize your blood sugar information.

Breakfast Lunch Supper Bedtime Night
Before After Before After Before After
Insulin
Blood sugar

Proper use of pen tips (needles)

Use pen tips only once; they are thin and can become bent or broken if re-used. Reusing pen tips can make the injection more painful. Leaving pen tips on the cartridge may cause leaking or allow air into the cartridge which may affect the concentration of the insulin.

Safe sharps disposal

Pen tips and lancets should be disposed of in a sharps container. Check with your local pharmacy. Many pharmacies supply safe, puncture-proof containers. When the container is full, it is returned to the pharmacy in exchange for a new container. Sharps otherwise should be disposed of in accordance with local regulations.

Diabetes Driving Guidelines

Using insulin can cause low blood sugar, and this can be very dangerous if you are driving. Learn about the important precautions you need to take before and while driving here.

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