Insulin therapy is a common and effective method for managing blood sugar levels during pregnancy for individuals with pre-existing diabetes or gestational diabetes. Proper insulin injection practices are important for both the pregnant individual and the developing baby. Correct injection techniques ensure insulin is absorbed as intended, contributing to stable blood glucose levels and supporting optimal health outcomes.
Recommended Injection Areas
Insulin is injected into the fatty layer just beneath the skin, known as subcutaneous tissue. The abdomen is a preferred site for insulin injection during pregnancy because insulin is absorbed consistently in this area. When injecting into the abdomen, stay at least two inches away from the belly button. This area can be used above or below the waist. Other suitable sites include the outer areas of the upper arms, the top and outer parts of the thighs, and the upper outer buttocks. For thighs, injections can be given on the top and outer aspects, approximately four inches down from the top of the leg and four inches up from the knee. These sites provide adequate subcutaneous fat for proper insulin absorption.
The Importance of Site Rotation
Regularly changing insulin injection sites is important to maintain consistent insulin absorption and prevent skin complications. Injecting repeatedly into the same spot can lead to a condition called lipohypertrophy, where fatty lumps or scar tissue build up under the skin. These lumps can interfere with insulin absorption, potentially causing blood sugar levels to fluctuate unexpectedly. Insulin absorption can be slowed by as much as 25% in affected areas.
Rotate injection sites within and across the recommended areas. For example, after injecting in one part of the abdomen, the next injection can be a finger’s width or about one inch away. Some individuals divide a chosen area, such as the abdomen, into four sections and rotate injections systematically within these sections, moving to a new section weekly. This systematic approach allows previous sites to heal, promoting consistent insulin action.
Proper Insulin Injection Technique
A consistent injection technique ensures effective insulin delivery. Before injecting, wash your hands thoroughly. Alcohol swabs are not always necessary if the skin is visibly clean; if used, allow them to dry completely before injection.
Pinching a one-to-two-inch fold of skin helps ensure insulin goes into the subcutaneous fat layer, not muscle, especially for thinner individuals or with certain needle lengths. Insert the needle at a 90-degree angle to the pinched skin for most individuals, though a 45-degree angle may be suitable for very thin people or shorter needles. Push the plunger down completely to inject.
After the insulin is delivered, leave the needle in place for five to ten seconds before withdrawing it to prevent leakage and ensure full absorption. Used needles should be disposed of safely in a sharps container or a hard plastic container with a tight lid.
Special Considerations During Pregnancy
Pregnancy introduces unique factors influencing insulin injection practices. As the abdomen grows, it remains a suitable injection site, but individuals may need to adjust by injecting into the lateral parts of the abdomen, away from the direct center or areas where the skin feels too tight. Finding a spot on the side of the belly where a skin fold can be gently raised is often helpful. The increased body fat distribution during pregnancy can also impact insulin absorption, making close monitoring of blood glucose levels important. Insulin requirements often increase as pregnancy progresses due to hormonal changes causing increased insulin resistance. Adjustments to insulin dosage and injection sites may be necessary to accommodate these physiological changes and support optimal glucose control. Your healthcare provider can offer personalized guidance.
When to Contact Your Healthcare Provider
Contact your healthcare provider if you notice any concerning signs at an insulin injection site. Symptoms such as redness, swelling, increased warmth, pain, or pus discharge could indicate an infection. Persistent bruising, lumps, or firm areas at injection sites that do not resolve should also be discussed, as these could be signs of lipohypertrophy or other issues affecting insulin absorption. If there are sudden or unexplained changes in blood sugar levels after injections, or if you have any concerns about your injection technique, seek medical advice.