Gestational diabetes: Giving yourself insulin shots

Insulin comes in small glass bottles (vials) and cartridges. Each type of container is sealed with a rubber lid. One vial or cartridge contains many doses. To remove a dose of insulin from:

• A vial: You will use an insulin syringe to get the insulin and to give yourself a shot.
• A cartridge: You will use a pen-shaped device called an insulin pen. The cartridge fits inside the pen and the dose of insulin is set with a dial on the outside of the pen. The pen (with the cartridge inside) is used to give the medicine. There are disposable and reusable insulin pens. Each pen works slightly differently.

Note: If you are using an insulin pen, talk with your doctor or pharmacist about how to use the pen correctly. Giving insulin with these pens is not covered in this information.

To give an insulin shot, the needle (attached to the syringe) is inserted through the skin. The medicine is pushed from the syringe into fatty tissue just below the skin. In pregnant women, insulin usually is given in the upper arm or thigh.

Your doctor may have you take two types of insulin at the same time. Most types of insulin that are prescribed to be taken at the same time can be mixed together in the same syringe.

Test Your Knowledge

1. To withdraw a single dose of insulin from a vial, I need to use a syringe.

   1. True

      This answer is correct.

      To withdraw a single dose of insulin from a vial, you do need to use a syringe.

   2. False

      This answer is incorrect.

      To withdraw a single dose of insulin from a vial, you do need to use a syringe.

2. To give a shot of insulin, the needle of the syringe is inserted into the skin, and the medicine is pushed into the fatty tissue just under the skin.

   1. True

      This answer is correct.

      To give an shot of insulin, the needle of the syringe is inserted into the skin and the medicine is pushed into the fatty tissue just under the skin.

   2. False

      This answer is incorrect.

      To give an shot of insulin, the needle of the syringe is inserted into the skin and the medicine is pushed into the fatty tissue just under the skin.

Normally, insulin is made by the pancreas. Insulin helps sugar (glucose) enter cells, where it is used for energy. It helps our bodies store extra sugar in muscles, fat, and liver cells. Later, that sugar can be released if it is needed. Without insulin, the body cannot use sugar, causing the blood sugar level to get too high.

If you have gestational diabetes during pregnancy, your pancreas cannot produce enough insulin. If regular exercise and changing the way you eat do not keep your blood sugar level within a safe range, you will need to take a man-made form of insulin. Keeping your blood sugar level within a safe range prevents complications for you, for your unborn baby (such as growing too large for normal delivery), and for your baby after birth (such as low blood sugar levels).

People who have type 1 diabetes and some people who have type 2 diabetes also need to take insulin.

Test Your Knowledge

1. Your body does not provide enough insulin to meet your needs if you have gestational diabetes during pregnancy.

   1. True

      This answer is correct.

      Your body does not provide enough insulin to meet your needs if you have gestational diabetes during pregnancy. If changing the way you eat and getting regular exercise do not keep your blood sugar levels within a safe range for you and your baby, you will need to take insulin.

   2. False

      This answer is incorrect.

      Your body does not provide enough insulin to meet your needs if you have gestational diabetes during pregnancy. If changing the way you eat and getting regular exercise do not keep your blood sugar levels within a safe range for you and your baby, you will need to take insulin.

2. Insulin shots help keep your blood sugar level within a safe range, preventing problems for you and your baby.

   1. True

      This answer is correct.

      Insulin shots help keep your blood sugar level within a safe range, preventing problems for you and your baby. High blood sugar levels during pregnancy can lead to high blood pressure for you. It can also cause your unborn baby to grow too large to be delivered normally and can cause the baby to have problems with low blood sugar after delivery.

   2. False

      This answer is incorrect.

      Insulin shots help keep your blood sugar level within a safe range, preventing problems for you and your baby. High blood sugar levels during pregnancy can lead to high blood pressure for you. It can also cause your unborn baby to grow too large to be delivered normally and can cause the baby to have problems with low blood sugar after delivery.

Your doctor will help you learn to prepare and give yourself insulin shots. Here are some simple steps to help you learn how to do it.

Get ready

To get ready to give an insulin shot, follow these steps:

1. Gather your supplies. You will need an insulin syringe , your bottle of insulin, and an alcohol wipe or a cotton ball dipped in alcohol. Most people keep their supplies in a bag or kit so they can carry the supplies with them wherever they go.
2. Check the insulin bottle label, expiration date, and contents. When you use an insulin bottle for the first time, write the date on the bottle. On the 30th day after opening it, throw the bottle away. Insulin may not work as well after 30 days.
3. Wash your hands with soap and running water. Dry them thoroughly.

Prepare the shot

Your preparation will depend on whether you are giving one type of insulin or mixing two types of insulin.

• To prepare a shot with a single type of insulin, follow the instructions in the slideshow of steps for preparing a single dose of insulin .
• To prepare a shot containing two types of insulin, follow the instructions in the slideshow of steps for preparing a mixed dose of insulin .

Prepare the site

Before giving your shot, take the time you need to do the following:

• Choose the place. See a diagram of shot areas for guidance. If you give your shots in different places on your body each day, use the same site at the same time of day.
• Clean the area. If you use alcohol to clean the skin before you give the shot, let it dry.
• Relax your muscles in the area of the shot.

Give the shot

Follow these steps for giving an insulin shot:

1. Slightly pinch a fold of skin between your fingers and thumb of one hand.
2. Hold the syringe like a pencil close to the site, keeping your fingers off the plunger. Usually the syringe is at a 90-degree angle to the skin site. If you are thin, you may need to insert the needle at a 45-degree angle. This will prevent the insulin from being injected into muscle, causing it to be absorbed more quickly.
3. Quickly push the needle all the way into the pinched-up area.
4. Push the plunger of the syringe all the way in so the insulin goes into the fatty tissue.
5. Remove the needle slowly at the same angle that you inserted it. If you bleed a little, apply pressure over the area using your finger, a cotton ball, or piece of gauze. Do not rub the area. Check your blood sugar more frequently on the days when bleeding occurs.
6. Replace the cover over the needle. Although syringe manufacturers do not recommend it, some people reuse their syringes until the needle becomes dull or bent. If you plan to reuse your syringe, see precautions when reusing syringes.

Clean up and storage

After giving your shot:

• Store your insulin properly so that each dose from the bottle will work well.
• Do not throw your used syringe, needle, or lancet in a trash can. You can dispose of it in a metal container that either has a lid that screws on or a lid that you tape down tightly. You also can buy special containers for disposing of used needles and syringes. Talk with your local trash disposal agency or your doctor about how to get rid of the container.

Other suggestions for success and safety

To help you be safe and successful in giving your insulin shots:

• Teach someone else to give your insulin shots. Have that person give you a shot from time to time so they will know how to do it in case of an emergency.
• Do not mix other medicine with insulin without your doctor's instruction. If you are taking two types of insulin, ask your doctor or pharmacist whether they can be mixed in the same syringe.
• Never share syringes with another person because of the risk of getting diseases that can be transferred through blood, such as HIV or infection of the liver (hepatitis).

Test Your Knowledge

Practice

Review the slideshow of steps for preparing a single dose of insulin . Give a copy of the steps to your doctor, certified diabetes educator (CDE), or other health professional and have him or her watch you prepare your dose of insulin. Ask the person to tell you how well you did. Repeat this process as many times as you need to.

Use the same process for preparing a mixed dose of insulin, if you need to take two types of insulin in one shot. Review the slideshow of steps for preparing a mixed dose of insulin .

Practice injecting air or water into an orange until you feel comfortable with the steps for giving insulin. Then repeat the steps in front of your nurse or certified diabetes educator, and ask him or her how you did. Practice more if you need to. If you feel you are ready, give yourself a dose of insulin while your doctor watches.

Answer these questions

1. The first step in preparing insulin from a bottle is to roll the bottle gently between your hands.

   1. True

      This answer is correct.

      The first step in preparing insulin from a bottle is to roll the bottle gently between your hands. This will warm the insulin if you have been keeping the bottle in the refrigerator. Roll a bottle of cloudy insulin until the white powder has dissolved.

   2. False

      This answer is incorrect.

      The first step in preparing insulin from a bottle is to roll the bottle gently between your hands. This will warm the insulin if you have been keeping the bottle in the refrigerator. Roll a bottle of cloudy insulin until the white powder has dissolved.

2. When you are preparing a cloudy and a clear insulin to give a mixed dose, which do you put into the syringe first?

   1. Cloudy insulin

      This answer is incorrect.

      When you are preparing a cloudy and a clear insulin to give a mixed dose, you put the clear insulin into the syringe first.

   2. Clear insulin

      This answer is correct.

      When you are preparing a cloudy and a clear insulin to give a mixed dose, you put the clear insulin into the syringe first.

Now that you have read this information, you are ready to start preparing and giving insulin shots.

Talk with your doctor or diabetes specialist

If you have questions about this information, take it with you when you visit your doctor or diabetes specialist.