Fear of Needles and Diabetes: insulin injection tips

Some people find the idea of injecting insulin to be overwhelming, and as a result, struggle to stick to their insulin regime or are hesitant to start insulin treatment when required¹. We have developed this guide for people with diabetes and their caregivers to help you become more confident about performing injections.

• Regularly changing where you inject your insulin can helpto prevent any skin irritation, lumps and indentations, and may reduce discomfort when injecting².
• Rotating insulin injection sites can help with insulin absorbtion².
• A common rotation regime is to use the same site for one month, divide each injection site into quarters and use a different quarter every week²:
  • At the beginning of each week, move in a clockwise direction one finger-width (2.5 cm) from the last injection point². 

Talk to your healthcare professional about the injection sites and rotation routines that are right for you.

Insulin pen needles and disposable syringes can come in different lengths and widths to suit all body types².

The good news is that the needles used for injecting insulin are much smaller and finer than those you might remember seeing for your vaccinations^2,3. So don’t worry! Your healthcare professional can help you find the needle size that works for you, so you can feel comfortable.

If you have any questions related to the type of needle you should be using, speak to your healthcare professional.

You might call it a fear of needles, or find yourself dreading any kind of injection. Sharp objects like needles and skin pricks are a common source of anxiety^2,3. When we think about injecting insulin, we often remember the injections for immunisation, which are done with a longer, bigger needle and given into muscle.

It is important to know the needles used to inject insulin are much smaller and finer. Nevertheless, worrying about having to inject with needles can still persist^2,3. 

There are many reasons why you may feel anxious when faced with needles. Try to understand why you feel the way you do, which could include¹:

• Not wanting to inject in public or in front of your friends
• The association of needles with failure or your disease severity
• The fear of pain or harm
• A fear of needles specifically

Finding a way to relax will help with your fear and anxiety. Make time in your day to practise some form of relaxation technique, such as deep breathing or guided meditations (in the form of CDs, books or mobile apps). You can also try to incorporate one of these techniques into your injection routine^4,5:

• Take control: Write down your fears and anxieties about injecting and rate them on a scale from 1-10. Choose the least worrying aspect and practise, practise, practise until it feels normal. Then, move up to the next one…
• Distract yourself: Try listening to music or talking to a loved one while doing your injection to take the edge off.
• Take advice from others: Speak to other people living with diabetes who self-inject and find out how they first coped when starting out. Search for local diabetes forums online or get in touch with your local diabetes patient group for more tips and advice.
• Keep trying: Not all techniques will work for everyone. To find the one that works for you, keep trying different ways to deal with your needle anxiety or go back to your healthcare professional.

Remember, it takes time to feel comfortable with giving an injection - do not rush yourself.

We understand that it is not easy to inject; no one enjoys injecting insulin every day. But changing a few basic things can make the injection procedure more comfortable⁵:

• Make sure your skin is clean and dry: You do not have to use alcohol on your skin unless you have been in a hospital or are unable to clean and dry your skin with ordinary soap and water. Wait for the alcohol from the swab to dry completely before you inject.
• Inject insulin that is at room temperature: It is more comfortable than when it is cold. Try and remember to take your insulin out of the fridge well before you need it.
• Make your injection site “numb”: Using a frozen spoon or ice cube wrapped in cloth, numbing cream from the pharmacy, or even simply applying pressure with your thumb to the injection site for a few seconds before injecting can make the injection hurt less⁶.
• Change your needle with each injection: Reusing your needle increases the risk of infection and new needles are sharper and cause less pain.
• Try and relax the muscles in the injection area.
• Rotate your injection site frequently to avoid damage to your tissues.

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