FIT Canada (Forum for Injection Technique) has created recommendations to help make your self-injections more comfortable and less intimidating. If you inject medications such as insulin, Ozempic, Wegovy, or Mounjaro, you may feel nervous about giving yourself injections and sometimes even experience pain. You’re not alone, many people feel uneasy, but after following the 7 tips below you should find it easier to give yourself injections with more confidence and more comfort.
Why Injection Technique Matters
Injection technique isn’t just about avoiding pain, it can also impact how well your medication works. Poor technique can lead to:
- Increased bruising or pain
- Improper absorption of medication
- Injection site issues like lumps or scar tissue called lipohypertrophy
That’s why it’s important to learn the "best practice" recommendations provided by FIT Canada and follow these on a regular basis.
1. Choosing the Right Needle
Shorter needles are better:
FIT Canada recommends 4mm, 5mm, or 6mm pen needles for all people with diabetes regardless of body mass index (BMI). Current research from across a wide range of BMIs support the use of 4mm pen needles. These needles are long enough to reach the subcutaneous (fatty) tissue (where these medications are absorbed) but short enough to reduce the risk of accidently injecting into muscle, which can cause pain and affect medication absorption.
Why shorter needles better:
- Less painful
- Lower risk of bruising
- Reduce chance of injecting into muscle tissue
- Easier technique - no need to pinch the skin for most people
Most medications are designed to work well with short needles, and your pharmacist can help you decide which is best for you.
Shorter needles are thinner:
- Shorter needles are made thinner. Longer needles have a larger diameter, since they need to be stronger.
- For example, a 4mm needle is usually 32 gauge, while a 8mm is often 31 gauge. (the higher the gauge the thinner the needle).
- Thinner needles cause less bleeding than a larger diameter needle.
- Studies show that bleeding is more likely to be associated with injection pain. Since smaller diameter needles cause less bleeding, they will cause less pain.
2. Pick the Right Injection Site
Proper site selection and site rotation is important. The most common sites for subcutaneous injections are the:
- Abdomen (2 inches away from the belly button)
- Upper thighs
- Buttocks
The back of the upper arms is NOT recommended for self-injection. This area should only be used by a caregiver with proper training.
The abdomen is commonly used for most medications, including insulin and GLP-1 receptor agonists (like Ozempic, Wegovy, and Mounjaro), because it typically has a layer of fat and offers better absorption. As well, this area is easy and convenient for most people while sitting.
Rotate Your Sites
Repeated injections in the same spot can lead to lipohypertrophy, a buildup of fatty tissue that makes injections more painful and can cause unpredictable absorption of the medication. Proper site selection and site rotation will help avoid this, make your injections more comfortable, and ensure the medication is absorbed optimally.
To prevent lipohypertrophy:
- Use different areas of the abdomen or thighs with each injection.
- Divide the injection area into zones and rotate within them. For example, split the abdomen area into 4 quadrants. Inject into a different quadrant each time, and also inject into a different spot within each quadrant every time you do an injection.
- Keep a simple log of injection sites or rotate in a clockwise direction.
3. Use a New Needle Every Time
Although it may be tempting to reuse needles to save money or reduce waste, it is always recommended to use a new needle for every injection. Even after one single use, a needle becomes dull and bent, and therefore causes more pain if used again. Furthermore, reusing a needle can also increase the risk of:
- Infection
- Skin irritation
- Lipohypertrophy
Using a new needle each time ensures a smoother injection and minimizes trauma to the skin tissue.
4. Preparation
- Prior to an injection, wash hands and ensure the site on body is clean.
- Inspect the area first (make this part of your regular routine). Look and feel for any signs of puffiness, raised areas, hardness, lumps, or redness. If it is difficult to see the area, a mirror may be helpful.
- Disinfection of the injection site with an alcohol swab is not usually required. However, if an alcohol swab is used, allow the area to air dry completely before injecting.
It is also important to:
- Avoid injecting into areas with bruises or irritation.
- Avoid moles, hair roots, scars, stretch marks, or other skin abnormalities.
5. Injection Technique
FIT Canada recommends the following technique:
- Insert the needle at a 90° angle for most adults and children over 6 years old for 4mm or 5mm needles.
- Push needle completely into the skin, but avoid pushing so hard that it causes skin to indent as this may lead to unintended injection into muscle tissue.
- Press the injection button completely and hold pen in place while continuing to press button for 10 seconds to ensure full delivery of medication (higher doses may require longer).
- Remove the needle straight out (avoid twisting or tilting).
- Gently press the site with a cotton ball if needed.
- Avoid rubbing or massaging the area after performing the injection as this may affect the absorption of the medication.
6. Store and Handle Your Medication Properly
Storing your medication correctly can make a big difference in injection comfort:
- Keep “in-use” pens at room temperature. Most products are stable at room temperature for 4 or more weeks, however check the package/information sheet in the box or ask your pharmacist for the storage recommendations for your specific product.
- Keep in the fridge (unless otherwise directed) the pens or vials that you have not started using yet. Avoid injecting a product cold. Let the pen come to room temperature for 15–30 minutes before use.
- Inspect the solution before injecting. If it’s cloudy, discolored, or contains particles (for medications that should be clear), do not use it and contact the pharmacy right away.
- Dispose of used needles safely in a sharps container, never discard in the garbage.
7. Ask for Help
Everyone’s experience with injections is different. If you’re struggling or unsure, ask your pharmacist for a demonstration. We’re happy to walk you through the technique, suggest the right products, and provide encouragement.
In Summary
Self-injections may seem intimidating at first, but they become easier with practice and proper technique. Click here to view FIT Canada’s full guide of recommendations for best practice, including those for pregnancy, pediatrics, and older persons.
Key Takeaways:
- Use a new, short needle each time (4mm is often best).
- Inject into a clean and healthy area.
- Rotate injection sites to avoid tissue damage.
- Insert the needle confidently and hold the pen in place while pressing the button for 10 seconds to ensure the full dose is administered.
- Ask your pharmacist for support at any time.
If you have any questions or would like a personal consultation, visit us in-store at Mayfair Pharmacy, or give us a call at 403-259-6893. We’re here to help you feel confident and supported in your journey toward more comfortable injections.