How is insulin given?

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How is insulin given?

You have two ways to take insulin for type 1 diabetes. Both use a needle. You can inject yourself with insulin using a syringe, or you may have a tube attached under your skin and connected to an insulin pump.

Syringes and pens

If you use a syringe to give yourself insulin, you can tightly control the mixture of insulin and where you inject it. But syringes may not be convenient for people who may need to inject insulin up to 4 times a day.

Some people use an insulin pen. It looks like a slightly oversized writing pen. A pen can come prefilled with insulin, or you can put a cartridge of insulin in it. A short needle is attached to the end of the pen. You can set the dose you need and then inject it through the needle. Many people, especially those on a multi-dose schedule, find insulin pens convenient and accurate. The cartridges come in many varieties of insulin, including premixed insulins. Disposable pens are also available.

Pumps

An insulin pump gives a preset amount (basal rate) of insulin to maintain a normal blood sugar level throughout the day and night. You can change the rate one or more times during the day. Additional doses of rapid-acting insulin can be given through the pump when you eat a meal and need extra insulin.

A tube connected to a catheter under your skin connects the pump to your body. You need to move the catheter every 2 to 3 days. The pump also uses a needle. Generally, only people with type 1 diabetes use the pump. The pump is sometimes a good choice for children with diabetes.

One drawback is that the tube can become blocked or dislodged. In such cases, while you may think that you are receiving insulin, your blood sugar may be rising, and it could lead to diabetic ketoacidosis.

Deciding which method of insulin administration you prefer is a complex decision. Think about your lifestyle and then look at which option best fits your needs. There are benefits and disadvantages to each tool, some of which are outlined in the table below.

**Advantages and disadvantages of insulin injections and pumps**
Method	Advantages	Disadvantages
Syringe injections	Does not require much equipment Complete control over your dosing, including insulin formulation No dependence on a mechanical device Less noticeable if you wear a swimsuit or other revealing clothing	Constant needle pricks and potential scar tissue buildup May be inconvenient if you are in public Syringe safety issues, such as reuse, infection, contamination
Pen injections	Does not require much equipment Easy to carry and use, especially for people on a multi-dose regimen No dependence on a mechanical device Less noticeable than a syringe and vials of insulin Some types may be easier to use for the visually impaired—some models make a “clicking” sound that helps to measure the required amount of insulin.	May be slightly more expensive Some insulin types and mixtures may not be available in pen or pen cartridge form.
Pump delivery	Less intrusive in your life overall Less painful: fewer needle sticks Provides as good or better blood sugar control as multiple insulin injections with fewer dangerous low blood sugar levels Increases flexibility in lifestyle, such as delaying meals, sleeping late, or variations in exercise levels Can be programmed for more than one rate to prevent low blood sugar levels, especially during the night	Tubing may become blocked or disconnected, leading to hyperglycemia, and possible diabetic ketoacidosis. Can still develop hypoglycemia, but usually less severe than with multiple insulin injections Possible infections and rash at injection site Possible weight gain from better blood sugar control Expensive

Experts are researching other ways to deliver insulin. Injecting insulin with needles is still the main way to treat type 1 diabetes.

Credits

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Author	Caroline Rea, RN, BS, MS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer	Matthew I. Kim, MD - Endocrinology & Metabolism
Last Updated	September 24, 2008

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Last updated:	September 24, 2008
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Matthew I. Kim, MD - Endocrinology & Metabolism
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC

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