Nurse preparing insulin injection with abstract medical background.

Insulin Injections: Are You Doing It Wrong?

Mira Elwood in Health & Wellness December 2025 • 3 min read.

"A new study reveals common insulin administration errors by nurses and what you can do to ensure proper technique."

For individuals managing diabetes, insulin injections are a cornerstone of treatment. Administering insulin might seem straightforward, but it requires precision and adherence to established medical guidelines. A recent observational study published in the journal Diabetes Spectrum sheds light on the current practices of insulin administration by nurses in a northern Greek hospital, revealing some surprising shortcomings.

The study highlights a gap between recommended practices and actual implementation, raising concerns about the potential for suboptimal diabetes management. These findings underscore the importance of staying informed and vigilant about proper injection techniques.

This article will delve into the key findings of the study, offering insights into common errors and practical tips for improving insulin injection techniques, whether you're a healthcare professional or an individual managing your diabetes.

What the Research Says About Insulin Injection Practices

Nurse preparing insulin injection with abstract medical background.

The observational study, conducted in a Greek public hospital, assessed the insulin administration practices of 20 nurses across two medical wards. Researchers used non-participant observation and post-hoc interviews to gather data, comparing the observed techniques against international guidelines. A total of 100 insulin administrations were observed, followed by interviews with eight of the nurses.

The study revealed several areas where practice diverged from recommended guidelines:

Hand Hygiene: Only 61% of nurses washed their hands before administering insulin.
Glove Use: 70% of nurses wore gloves during injections. However, gloves were not always changed between patients.
Insulin Vial Preparation: A significant 64.5% of nurses did not clean the insulin bottle before inserting the needle.
Air Bubble Check: 42.7% of administrations did not include a check for air bubbles in the syringe.
Injection Site Assessment: In nearly 90% of cases, nurses failed to check the injection site for appropriateness or potential complications.
Skin Antisepsis: While 90.9% cleaned the skin with an alcohol swab, the necessity of this step has been questioned in recent literature.
Injection Angle: 70.9% of injections were administered vertically without creating a skinfold.
Post-Injection Care: A staggering 89.1% of instances were rated as having poor post-injection care, with insufficient time allowed before needle withdrawal.

These findings indicate a concerning level of non-compliance with established guidelines, potentially impacting the effectiveness and safety of insulin administration.

Practical Tips for Improved Insulin Injections

Whether you're a healthcare provider or managing your own diabetes, adopting best practices for insulin injection is crucial. Here's a concise guide:

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2337/ds16-0001, Alternate LINK

Title: In-Hospital Administration Of Insulin By Nurses In Northern Greece: An Observational Study

Subject: Endocrinology, Diabetes and Metabolism

Journal: Diabetes Spectrum

Publisher: American Diabetes Association

Authors: Dimitrios Theofanidis

Published: 2017-08-01

Everything You Need To Know

What were the main issues with insulin administration practices that were identified in the study?

The study revealed that a significant percentage of nurses did not adhere to recommended practices for insulin administration. Specifically, there were issues with hand hygiene (61% washed hands), glove use (70% used gloves, but not always changed between patients), insulin vial preparation (64.5% did not clean the vial), air bubble checks (42.7% didn't check), injection site assessment (90% failed to check), injection angle (70.9% injected vertically without a skinfold), and post-injection care (89.1% had poor post-injection care). Each of these deviations can impact the effectiveness and safety of insulin delivery.

Why are hand hygiene and proper glove usage so important when giving insulin injections, and what did the study reveal about these practices?

Proper hand hygiene, which involves washing hands before administering insulin, is crucial in preventing infections. The study showed only 61% of nurses followed this guideline. Furthermore, while 70% of nurses used gloves, they weren't always changed between patients, posing a risk of cross-contamination. The failure to clean the insulin vial before use (64.5% did not) introduces another potential source of contamination. These lapses in basic hygiene can compromise patient safety and increase the risk of localized or systemic infections.

Why is it necessary to check for air bubbles and assess the injection site before administering insulin?

Checking for air bubbles in the syringe, which 42.7% of administrations omitted, is important because injecting air can affect the accuracy of the insulin dose. Failing to assess the injection site, which occurred in nearly 90% of cases, can lead to complications such as lipohypertrophy (fatty lumps under the skin) or infections. Both of these errors can impact insulin absorption and glycemic control. Injection site rotation is a key element that reduces these risks.

How does the angle of injection and post-injection care affect insulin absorption and effectiveness?

Administering insulin at the correct angle, often involving a skinfold to ensure subcutaneous injection, is vital for proper absorption. The study found that 70.9% of injections were given vertically without creating a skinfold, potentially leading to intramuscular injections, which have a faster and less predictable absorption rate. Poor post-injection care, observed in 89.1% of instances, including insufficient time before needle withdrawal, can cause insulin leakage and impact the dose delivered. Appropriate technique ensures consistent and predictable insulin absorption.

Does the research discuss specific types of insulin or needle sizes and their effects on the injection process?

The study did not directly address specific types or brands of insulin, or the impact of different needle sizes. These factors can influence insulin absorption rates and injection comfort. Different types of insulin (rapid-acting, short-acting, intermediate-acting, long-acting) have different onset and duration of action, and the correct choice depends on individual needs and blood glucose patterns. Needle size also impacts injection depth and patient comfort, with shorter needles often recommended to reduce the risk of intramuscular injection.