Why Technique Matters

Poor injection technique leads to uneven absorption, unexplained highs/lows, and painful

lumps (lip hypertrophy). Proper technique ensures effectiveness.

Where to Inject?

Area Tips

-Abdomen Best for rapid absorption; stay 2 inches away from navel

-Thighs Slower absorption; good for basal insulin

-Upper arms Use fleshy part at the back

-Buttocks Alternate if other sites sore

How to Rotate Sites

-Divide each area into quadrants or zones

-Use a new zone each week

-Stay 1 finger-width apart from last injection

-Never inject into hard lumps

Needle Tips

-Use new needles every time

-4mm/6mm needles are sufficient

-No need to pinch skin if needle is short and person is lean

Storage

-Unopened: Keep insulin in fridge (2–8°C)

-Opened: Can be kept at room temp for 28 days, away from sunlight

Take-Home Messages:

Technique matters more than timing. Rotate, inject correctly, and don’t fear insulin — it’s

life-saving.

References: ADA 2025, RSSDI 2024, Endocrine Society of India

Smrithi (name changed )is a 14 year old girl who's suffering with type 1 diabetes since 2 years. She had come to the type 1 clinic. She was a shy kid . I tried to converse with her . She had completed 8th grade in Bidar a small town in karnataka. Her village didn't have school beyond that. If she was to pursue her 9th grade she would have to leave her home and stay in hostel. So, a diagnosis of type 1 diabetes was like death knell for her studies. Her family felt that she couldn't manage diabetes in a hostel. I asked her if she was taking her insulin and how she was storing it. She said she kept it in a cool earthen pot as her family couldn't afford a fridge.

Laxmi (name changed) is the mother of a Type 1 diabetic kid who hadn't come to the clinic . The child had gone to school. when asked how she stored the insulin she replied that they didnt have a fridge , but were storing it in their neighbours fridge.

I met a cute little girl who came with her father .She was 11 years old. I asked her how she was managing Type-1. She showed me plastic tiffin box which she took out from her back pack. The multi coloured tiffin box had her insulin pen and an ice pack. I was pleasantly surprised at her preparedness. I quizzed her a little more, asked her if she had low sugars what would she feel and how she would manage it. She promptly and correctly answered as testified by the doctors present there. She was well prepared and diligent with her treatment. I glanced at her father he was tearing up with a smile on his face. That visual was beautiful, positive, optimistic and encouraging.

There must be scores of such families who cant afford a fridge. So, how can they store the insulin ?

Tips to store when fridge is not available-

we need 2 earthen pots -one fitting into the other to make an indigenous low cost insulin storage.

a small pot which can hold the insulins and a bigger pot which can hold the smaller pot .

Larger earthen pot filled with wet sand. Make a space to fit the smaller pot in the middle of the sand filled larger pot and store your insulin in the smaller pot. the wet sand has to be kept wet. So, don't forget to keep pouring a few drops of water every 4-6 hours and leave it in a dark cold corner of your house

credits:https://iapindia.org/pdf/Ch-022-STG-Diabetes-Mellitus.pdf

youtube link: https://www.youtube.com/watch?v=ZtL7c75NNwM (courtesy: Dr Archana Sarda)