For patients with diabetes in settings where long-term care pharmacy is used to support medication management, administering insulin is a common responsibility of a facility’s nursing staff. Insulin is a critical treatment for these patients, so it’s important that nursing teams stay up to speed on best practices for the insulin injection process – from choosing the best injection site to their care after administration. Read on for our quick and easy guide to safely managing the insulin injection process from start to finish.

Choosing an insulin injection site

Insulin injection sites are not all created equal when it comes to rates of absorption. For example, the absorption rate from the abdomen is more predictable and consistent than that of the arms, thighs, or buttocks. However, absorption rates can also vary within the same area. A few things to keep in mind:

  1. Injecting into the same spot repeatedly may lead to lumps or thickened tissue that can delay insulin absorption or cause discomfort. Make sure to rotate and track injection sites to avoid overusing certain areas. 
  2. When injected into fatty tissue rather than muscle or bone, the body absorbs insulin more effectively. Areas of the body with a higher fat concentration, such as the abdomen, buttocks, or thighs, are ideal injection sites, as the body absorbs insulin most effectively in these areas.
  3. Steer clear of areas with prominent bones or scars.

Safely navigating the insulin administration process

Once you’ve determined the site for your insulin injection, it’s time to administer the drug.

  1. Before giving an insulin injection, always wash your hands with soap and water to reduce the risk of infection. Once your hands are clean, you can use an alcohol pad to clean the injection site that you’ll be using Avoid touching anything else until after you’ve administered the injection.
  2. Hold the injection device at an upright angle to prevent insulin leakage during the injection. Remove the cap from the needle and check the insulin for any particles or change in color before use. If you notice anything strange, do not use the insulin.
  3. Insert the needle at a 90-degree angle to the skin. In thinner patients, it is recommended to use an angle of 45 degrees to reach the subcutaneous fat layer.
  4. Make sure to inject insulin slowly for a better absorption rate. Once the injection is complete, gently remove the needle and use an alcohol pad to press down on the injection site to stop any bleeding.
  5. Always dispose of used needles in a sharps container. Do not throw used needles in the garbage or recycling bin.

Care after administration

  1. Avoid massaging insulin injection sites. After injecting insulin, it is tempting to rub or massage the site to alleviate pain or improve insulin absorption. Unfortunately, doing so can stimulate blood flow and interfere with insulin absorption. It can also cause bruising or bleeding, which may affect blood sugar levels. Instead, leave the injection site alone for a few seconds to absorb the insulin fully.
  2. Keep insulin injection sites clean and hygienic. Cleaning the skin with alcohol swabs before injecting insulin can help remove bacteria and ensure that the injection site is clean. However, it is important not to overuse alcohol swabs as they can irritate the skin and cause dryness. Also, be sure to let the skin dry before injecting insulin to prevent stinging or discomfort.

At Grane Rx, we are committed to supporting the staff in skilled nursing facilities. Through our education programs, we empower nursing teams to navigate the complexities of blood sugar management effectively. By enhancing understanding of the insulin injection process, staff can reduce complications resulting from high or low blood sugar levels.

Learn more about our long-term care pharmacy services and how we could partner with your organization by calling (866) 824-MEDS (6337) or emailing