There are many different types of medicines available to treat diabetes. Some of these medicines need to be injected. Read on for more information about injectable medicines for diabetes and tips for using them safely and effectively.

What is diabetes?

Diabetes is a medical condition where the body can't maintain healthy levels of glucose (sugar) in the blood. There are a few different types of diabetes including type 1 diabetes, type 2 diabetes and gestational diabetes. The goal of treatment in all types of diabetes is maintaining healthy blood sugar levels.

How is diabetes treated?

If you have diabetes, it is important to eat a balanced diet and exercise regularly, as this will help you maintain healthy blood sugar levels.

Many people with diabetes also need medicines to help them manage their blood sugar levels. There are many different medicines available. Some medicines come in tablet form, while others need to be injected.

What is insulin?

Insulin is a hormone naturally made by the body. It helps your body move the sugar from the food you eat into your cells, where it can be used as energy.

If you have diabetes, your body may not have enough insulin to control your blood sugar. Insulin can be given as a medicine to help you maintain healthy blood sugar levels.

At present, insulin is only available as an injection.

What devices are available to deliver insulin to the body?

A range of devices can be used to deliver doses of insulin to the body. These include:

• insulin pens
• insulin pumps
• insulin jets
• syringes

What are insulin pens?

Insulin pens look similar to a fountain pen, and may come pre-filled or with refillable insulin cartridges. The required dose of insulin is automatically measured and delivered by a needle attached to the pen.

Many different types of insulin pens are available, but most work in the same way.

Using an insulin pen

If you have a reusable insulin pen, insert an insulin cartridge and dial the right dose. Your doctor, pharmacist, or diabetes educator can show you how. Give yourself the injection, and then dispose of the needle in a sharps bin.

If you are using a disposable insulin pen, dial the right dose, give yourself the injection and then dispose of the pen in a sharps bin.

What other injectable medicines are used to treat diabetes?

There are a number of non-insulin treatments for diabetes, some of which are injected into the body. Non-insulin injectable medicines also use an injection device called a pen.

How do I use my pen delivery device?

You may be given a pen delivery device to inject insulin or a different, non-insulin diabetes medicine. While the different medicines work differently, the pens used to administer them often work in a similar way.

Here are some tips for using your pen delivery device safely and effectively:

• Prime (prepare) your pen before using it by dialling in a very small amount of medicine and then expel (eject) it into the air. Then dial in your correct dose and inject. This ensures the needle is working before use and that no air bubbles are injected into your skin.
• To avoid medicine leakage, pinch your skin, inject the needle and then slowly remove the needle at the same angle at which you put it in. Press on the injection site for a few seconds to stop any insulin leaking out.
• If any medicine leaks or spills when you are using your pen, do not take another dose. Monitor your blood sugar level until your next dose is due, then continue to take your medicine as normal.
• Remove the needle from the pen immediately after use and safely dispose of in a sharps bin.
• Never inject through clothing — this can cause soreness and infection. It also blocks your view of the injection site, making it hard to tell if the injection has been successful or not.

How do I avoid problems with my pen delivery device?

• Always keep your pen separate from the needles until you need to use it — do not carry the pen around loaded with a needle.
• Make sure you have a spare insulin pen in case yours breaks or gets lost. If you use the spare, make sure that you replace it immediately.
• Never attempt to use a pen that is not working properly — use your spare instead. If you don't have one, contact your doctor or diabetes nurse educator for advice.

What are insulin pumps?

Insulin pumps (also known as continuous subcutaneous insulin infusion, or CSII) are devices worn on the body 24 hours a day. They automatically deliver a continuous dose of insulin according to your needs.

The pump works with an ‘infusion set' that helps the insulin enter your body. This is made up of some thin plastic tubing, an adhesive (sticky) patch, and a small needle-like device called a cannula. Infusion sets need changing regularly — usually every 3 days.

An insulin pump does not monitor your blood sugar level. You need to use diabetes testing equipment to do this.

The insulin that the pump uses is fast-acting and disappears from your body quickly once the pump is disconnected. If this happens, your blood sugar level will start to rise, and you may be at risk of high blood sugar (hyperglycaemia)

Tips for using your insulin pump

• If you need to disconnect your pump, make sure it is back in place within one hour.
• Move your cannula site (the place on your body where the cannula goes) regularly, to avoid too much scar tissue developing.
• If your pump is leaking insulin, or you notice damp patches on your clothes, change to a new infusion set.
• If your pump is not working properly, contact the manufacturer and your diabetes nurse or educator for advice.

What are insulin jets?

Insulin jets are a needle-free method of delivering insulin to your body. This can be useful for people who don't like needles or are unable to use needles. You draw the insulin into the nozzle, and it is delivered at high speed so it penetrates your skin.

What are syringes?

Syringes were once the standard way to inject insulin into the body. These days, this method is far less common than using insulin pens, which are more convenient and easier to use. If you use a syringe to inject your diabetes medicine, talk with your doctor or diabetes educator to check if a pen device is more suitable for you.

Avoiding problems with your syringe

• If insulin leaks or spills when you are injecting, do not take another dose. Monitor your blood sugar level until your next dose of insulin is due, and then take that as normal.
• Make sure you keep a supply of spare needles and syringes.
• Always dispose of your needles and syringes safely in a sharps bin.

Resources and support

You should talk to your health professional about the benefits and risks of getting a medical implant. Use the Therapeutic Goods Administration's guide on what to ask. The information is in English, Arabic, Croatian, Farsi, Greek, Italian, Korean, Mandarin, Spanish, Turkish and Vietnamese.