Pens, needles and injections

Some people find the idea of giving injections to be overwhelming and experience difficulty coping. We have developed this guide to help you become more confident about performing injections.

Choosing the correct place to inject is important. The main injection sites are the thighs, abdomen (stomach), buttocks or backs of the upper arms.

• You should not inject in the same site every time
• Rotating injection sites will give each site the opportunity to recover properly and will make injections more comfortable and effective
• One rotation routine is to divide each injection site into halves or quarters and use a different half or quarter every week:
  • At the beginning of each week, move in a clockwise direction one finger-width from the last injection point

Talk to your doctor or nurse about the injection sites and rotation routines that are right for you.

Sharp objects like needles and skin pricks can be a source of anxiety. 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, the anxiety from having to inject with needles can still persist. Here are some tips and tricks you can try to help you work through it.

There are many reasons why you might feel anxious when faced with needles. Try to understand why you feel the way you feel about needles, which could include:

• 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 anxiety. Make time in your day to practice 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:

• Take control: Write down your anxieties about injecting and rate them on a scale from 1-10. Choose the least worrying aspect and practice, practice, practice 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 patients 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 doctor or nurse

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 every day. But, changing a few basic things can make the injection procedure more comfortable:

• 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 have your skin cleaned and dried 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 less
• Change your needle with each injection. Reusing your needle increases the risk for 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