How to give insulin
Other platforms explain it with text and video. In VMS you practice it on the patient.
Insulin is a high-alert drug: a small mistake can cause a dangerous low blood sugar. Matching the right insulin to the glucose and the meal keeps patients safe.
What you need
- Insulin vial or pen
- Insulin syringe or new pen needle
- Alcohol swab
- Glucose meter
- Sharps container
Step by step
Check glucose and food
Check the blood glucose and confirm the patient can eat. Rapid-acting insulin should be given close to the meal, usually within 15 minutes. [1]
Verify type and dose
Compare the insulin name, type and units with the order. Many facilities require a second nurse to check the dose independently. [1]
Prepare the insulin
Roll cloudy insulin such as NPH gently between your hands; do not shake. Use an insulin syringe marked in units, or prime a pen with 2 units. [2]
Choose and rotate the site
The abdomen absorbs fastest; the arm, thigh and buttock also work. Stay at least 2 inches (5 cm) from the navel and rotate within an area. [2]
Inject
Pinch the skin if the patient is thin and insert at 90 degrees, or 45 degrees with a longer needle. Inject, and with a pen hold for about 10 seconds before removing. [2]
Watch for low sugar
Check for sweating, shaking and confusion, especially at the insulin's peak time. Treat a glucose below 70 mg/dL per your hypoglycemia protocol. [1]
Document
Record the glucose, insulin type, units, site and time. Write the word units in full. [3]
Common errors
- Writing U for units, which can be misread as a zero.
- Giving rapid-acting insulin when the meal is not coming.
- Using the same spot every time, causing lumpy skin and poor absorption.
Common insulin types (approximate times; check the product label) [1]
| Type and examples | Onset | Peak and duration |
|---|---|---|
| Rapid-acting (lispro, aspart, glulisine) | About 15 minutes | Peak 1 to 2 hours, lasts 3 to 5 hours |
| Short-acting (regular) | 30 to 60 minutes | Peak 2 to 4 hours, lasts 5 to 8 hours |
| Intermediate (NPH) | 1 to 2 hours | Peak 4 to 12 hours, lasts 12 to 18 hours |
| Long-acting (glargine, detemir, degludec) | 1 to 2 hours | Little or no peak, lasts about 24 hours or more |
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- Open RN, Nursing Pharmacology 2e (CC BY 4.0)
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- The Joint Commission, National Patient Safety Goals
Steps adapted from Open RN, Nursing Pharmacology 2e and Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. VMS is not affiliated with these organizations. Updated: 2026-10-11.