DFU Manual - Episode 8 - Insulin

Insulin is fast to give, barely hurts, and steady glucose is what actually lets a diabetic foot wound close. Episode 8 of the Diabetic Foot Manual walks through how to use it safely — with a pen or a syringe — and how to avoid the one syringe mistake that causes the most dosing errors. ### Why insulin, and where it goes Modern pens use ultra-fine needles that most patients barely feel. Insulin is used when pills aren't enough to control blood sugar, and it's injected into the fat just under the skin. Good sites include: - The abdomen - The outer thigh - The outer arm - The outer gluteus Pinch the skin gently and flat, and rotate sites every time so the tissue stays healthy. ### The four-step pen sequence 1. Prepare — wash hands and attach a fresh needle. 2. Safety test — dial 2 units and press until a drop appears at the tip. 3. Dose and inject — dial the prescribed dose and inject. 4. Hold for 10 seconds — so the full amount actually enters, then dispose of the needle in a sealed, rigid container. If a pen isn't available, a syringe works: draw air equal to your dose, pull the insulin, clear any bubbles, pinch the skin, insert at 90°, push the plunger, count to ten, and remove. ### One critical syringe warning On a tuberculin syringe, 0.2 mL equals 20 units and each line is 1 unit. Confusing milliliters with units causes dangerous dosing errors — only use a tuberculin syringe if nothing else is available. ### Six habits that keep insulin safe - Rotate sites so the skin doesn't harden - Hold each injection for 10 seconds - Never share needles — they are single use - Dispose of needles in a sealed, rigid container - Store open insulin at room temperature for ~28 days; keep spares in the fridge - Never skip doses while a wound is healing Original content by Alianza Para El Salvataje del Pie Diabético Perú, brought to you by Pingoo and WoundScribe AI. Next episode: meet Victor, and learn why a black toe is a true emergency.