The NDSS is administered by Diabetes Australia

Insulin - the key

Now you’re living with type 1 diabetes, you would have started on insulin as soon as you were diagnosed. This is to replace the insulin your body no longer makes.

Insulin is an essential part of managing your diabetes and will help keep you feeling well.

Why you need insulin

Insulin is a hormone made by the pancreas. The pancreas is an organ in your body. The easiest way to describe insulin is as a key that unlocks the cells in the body to let in glucose to be used as fuel or energy.

Type 1 diabetes is an autoimmune condition where the person’s immune system attacks the cells in the pancreas that make insulin. Without insulin, glucose builds up in the bloodstream, leading to high glucose levels.

Not having any insulin will cause high blood glucose levels and make you wee a lot, feel tired and thirsty, and lose weight. It can also lead to you becoming seriously unwell with diabetic ketoacidosis (DKA). Replacing the insulin your body no longer makes with insulin injections or via an insulin pump is life saving when you have type 1 diabetes.

Replacing insulin

Everyone with type 1 diabetes needs to replace the insulin their body no longer makes. The insulin you inject, has the same effect as the insulin that was made by your pancreas. There are several ways to do this. You’ll be able to work with your diabetes health professionals to help you decide which method is best for you. It may be with an:

  • insulin syringe
  • insulin injection device (insulin pen) and pen needle
  • insulin pump.

The method you chose may change in the future; especially as new technology becomes available.

Your personal insulinroutine

Your diabetes doctor (endocrinologist, paediatrician, or other diabetes specialist) or diabetes nurse practitioner will work with you to plan the type and amount of insulin you need over the day. While there are different brands of insulin, they all fall into three groups.

A basal insulin is a long-acting insulin. It works slowly and is often described as a background insulin. Basal insulin works over 24-36 hours to keep your blood glucose level stable between meals and overnight. It should be injected at the same time each day but doesn’t need to be taken with food.

A bolus insulin is a rapid or short-acting insulin. It works quickly and helps balance your blood glucose level over 2-6 hours. Bolus insulin is given with a meal and sometimes with a snack. The dose is calculated based on the amount of carbohydrates (carbs) you will have and the blood glucose level. This is called the insulin to carb ratio (ICR).

Bolus insulin can also be used to correct a high blood glucose level.

A “mixed insulin” has a combination of a bolus and basal insulin. It’s usually injected once or twice a day.

How to inject your insulin in six easy steps


  • Wash and dry your hands.
  • Get your pen, needle, insulin and sharps container.

Prep your pen

  • Take lid off the pen and peel paper backing off the needle.
  • Screw needle onto pen and remove the safety caps.

Prime your pen

  • Dial up two units of insulin for priming the pen.
  • Push the two units into the air and then dial up your required dose.

Choose your injection site

  • Choose a different injection site from the last one you used.
  • Press down with your thumb and pointer finger 2-3cm (1 inch apart).
  • Insert the needle into the skin at a 90 degree angle.

Inject your insulin

  • Push the end of the pen with your thumb until it “clicks” back to zero.
  • Count to 10 slowly, then remove the needle.

Clean up

  • Unscrew the needle and dispose into your sharps container.
  • Store your insulin in a cool spot, out of direct sunlight.

Where to inject

Different sites may cause the insulin to work faster or slower depending on the type of insulin you use. This is the same if you’re using a syringe, insulin pen and pen needles, or an insulin pump.

Insulin is injected into the fatty (subcutaneous) layer under the skin. The more common sites used are the tummy (abdomen) and upper buttocks.

If using arms or thighs, it’s important to avoid injecting into the muscle. The insulin will be absorbed much faster in a muscle, increasing the risk of a hypo.

Talk to your diabetes health professional about which injection sites you can use.

Rotate your injection site

It’s important to “rotate” injections within your chosen injection site. Lipohypertrophy is a firm, fatty lump that appears on the skin. It happens when injecting in roughly the same spot over a long period of time. This changes the appearance of the skin and can also affect how quickly insulin is absorbed.

If you find a fatty lump, avoid using the area until the lump is gone. Talk to your diabetes health professionals if you’re worried about your injection sites.

An easy way to rotate insulin injection sites is to imagine a flower shape on your stomach, like in this diagram. Use one petal of the flower each day of the week to inject insulin, with each injection being in a slightly different spot in that petal.

  • Always use a new spot for each injection or when inserting a cannula.
  • Use a pattern to space out the sites you use such as on this diagram.
  • Always inject at least 1cm away from your belly button and 1cm away from your ribs.
  • Avoid injecting two different insulins in the same spot.
  • Check your injection sites regular by running your finger over the site, feeling for any changes.

Insulin injecting tips

No one really likes having injections. The good news is that the pen needles and cannulas are now very fine, and generally, injections are pain free. Just in case, here are a few tips to reducing the pain.

Using a blunt needle can cause bruising and pain.

Top tip: Change your pen needle with every injection.

medicine icon

Some medication such as aspirin can cause bruising and bleeding.

Top tip: Apply pressure over the injection site with your fingers for 50 seconds after injecting.

Using cold insulin can cause stinging and pain.

Top tip: Use insulin at room temperature between 4-25 degrees Celsius.

Some insulins can cause burning or stinging when injected.

Top tip: Choose a slightly longer needle length, for example change from a 4mm to a 5 or 6 mm pen needle.

Getting anxious when having to inject?

Top tip: Find some relaxation techniques such as slow breathing.

Talk to your diabetes health professionals if you’re struggling with your injections. They can help you find some solutions.

Using apump

An insulin pump is a programmable device, smaller than a smartphone. It uses rapid-acting insulin only. It’s connected through a small plastic cannula that sits under the skin. Most pumps use tubing to deliver the insulin from the pump to the person. But there is also a pump that is tubeless called a pod.

Pumps are programmed to automatically deliver the basal insulin in small amounts over 24 hours. Bolus insulin is given at mealtimes or when the blood glucose level is above the target range, with the press of a button.

If you decide to use a pump, your diabetes health professionals will:

  • work with you to choose the pump that is right for you
  • support you getting a pump
    help you to set up the pump program
  • teach you how to use the many features.

Is a pump right for you?

There’s a lot to think about when deciding to use a pump.
Here’s a list for you to think about.

  • A pump can give you the right amount of insulin at the time you need it.
  • There are less risks of having blood glucose levels outside your target range when using a pump.
  • You will need fewer injections when using a pump.
  • You can set alarms, for example, if the pump stops working.
  • Using a pump will give you more flexibility with food and drink. You can eat when you want and what you want.
  • Using a pump will give you more flexibility with managing exercise, travel, work and study. 
  • The price of the pump and ongoing cost for cannulas and tubing can make it more expensive.
  • Being attached to a pump all day every day can be challenging, and although small it’s often visible.
  • Changing the cannula takes longer than an injection, and some times it may be necessary to do this at a time that doesn’t suit you.
  • It’s often a steep learning curve to start counting carbs and program the pump.
  • Using a pump increases the risks of getting skin infections and can lead to allergy to the tapes used to hold the cannula in place.
  • You can be at increased risk of DKA if the pump malfunctions, the cannula is blocked or displaces, or there’s an air bubble in the tubing. 

How to store your insulin

Using insulin, isn’t just learning to give an insulin injection. It’s also about finding out how to store it safely. You also need to know how to dispose of the used equipment.

Tips for insulin storage:

Keep any insulin you are not using in the fridge. The ideal storage temperature is 2 to 6°C.

Keep your insulin out of direct sunlight in a cool cupboard or cooler bag.

Room temperature is usually fine for insulin you’re using that day. Be careful if the heating is on or it’s summer.
Check the pack for the expiry date and don’t use it if it has expired.
Never freeze insulin. If you do, throw it away.

If you leave insulin out of the fridge for 28 days or more throw it away as the insulin will have broken down.

Insulin should never be shaken vigorously.

Some insulins may need to be stored differently. Read the information that comes with it, or ask your diabetes health professionals for advice.

Getting rid of your sharps

You will need to dispose of your used syringes, pen needles or used cannula and inserter in a safe way.

They’re called sharps because they puncture your skin.

Just throwing your sharps out in your general garbage, household recycling or public litter bins increases the risk of a needle stick injury. This may affect people who handle your garbage, the people around you or even children.

  • To avoid a needle stick injury, make sure your sharps are disposed of in a strong, plastic, screw top container that’s puncture proof.
  • You can purchase an Australian Standard Sharps container, or you can use a strong plastic container with a tight-fitting screw top lid such as a bleach bottle.
  • Avoid using thin plastic containers that may be pierced, glass, cardboard or aluminium containers as they’re not puncture or shatter proof.
  • Only put sharps in your sharps container.
  • Used wrappings or paper waste can be safely disposed of in your household garbage bin.
  • When your container is full, seal the lid firmly and take it to your local sharps disposal site where it will be incinerated. This may be at your local hospital, council, or pharmacy.

Where to get supplies

  • A disposable pen device: This device is supplied with the insulin, when your prescription is filled at your pharmacy. An alternative is a reusable pen device supplied by your diabetes educator or pharmacy.  
  • Insulin: Your doctor or diabetes nurse practitioner will give you a prescription for insulin. It comes as 5 boxes. Each box has 5 cartridges for a reusable pen or 5 disposable pens.
  • Pen needles: Pen needles are fully subsidised by the NDSS and supplied by your local NDSS Access Point (Access Point), usually a community pharmacy.
  • Insulin pump supplies: Insulin pump supplies (cannulas and tubing) are subsidised by the NDSS and supplied by an Access Point.

NDSS Registration

Your NDSS registration gives you access information, programs, support services and subsidised diabetes products through your local pharmacy.

  • Call the NDSS Helpline 1800 637 700 and ask to speak to a diabetes health professional about how the NDSS can support you. We’re here to help.
  • Sign in to My NDSS to access the support that is available to you and your family.