Subcutaneous Injection Administration

Preparation and Technique

The American Diabetes Association recommends cleaning hands and gathering all necessary supplies, including medication, syringe with appropriate needle, alcohol swabs, and sharps container, before administering a subcutaneous injection 2, 3
The proper technique for subcutaneous injection involves using a 4-mm pen needle inserted at a 90-degree angle into appropriate subcutaneous tissue, after proper site selection and preparation, to ensure medication is delivered safely and effectively, as recommended by the Mayo Clinic 1
For cloudy insulin preparations, gently roll the vial between palms or shake gently to resuspend the insulin, as recommended by the American Diabetes Association 4, 5
When using a vial, inject an amount of air equal to the dose you'll withdraw to avoid creating a vacuum, as recommended by the American Diabetes Association 4
The American Diabetes Association recommends rotating injection sites systematically within one area to maintain consistent absorption 6, 7

Recommended sites for subcutaneous injection include the abdomen, upper third anterior lateral aspect of the thighs, posterior lateral aspect of the upper buttocks and flanks, and middle third posterior aspect of the upper arm, as recommended by the Mayo Clinic 1, 6
The abdomen has the fastest absorption rate, as noted by the Mayo Clinic 5
Avoid areas with lipohypertrophy, inflammation, or scarring, as recommended by the American Diabetes Association 6

For insulin injections, use 4-mm pen needles for all patients regardless of age, BMI, or body type when possible, as recommended by the Mayo Clinic 1
For cloudy insulins, ensure proper resuspension by rolling and tipping the vial/pen 10 times, as recommended by the American Diabetes Association 4
Store unopened insulin in refrigerator; in-use insulin can be kept at room temperature (below 86°F/30°C) for specified periods, as recommended by the American Diabetes Association 4
For children and thin adults, use shorter needles (4-mm) when possible and a 2-finger lifted skinfold technique to prevent intramuscular injection, as recommended by the Mayo Clinic 1, 5