IM injections revisited: Tips, good practices, etc

It's the holidays, and despite my best behavior, I woke up this morning @ 250, after over-indulging on shortbread late last night.

So, I went for the "fast" correction -- an IntraMuscular injection. I generally get about 2x the speed with humalog this way, even a bit faster if I am physically active after the IM injection. It's become a routine tool in my D management regimen.

I respectfully ask that we keep this discussion to how, where, when, etc. to do IM's -- debate over the propriety of it, please leave to another discussion. I'm very interested in hearing from others that regularly use IM regarding their tips and tricks.

My contribution

Just a few tips that have worked well for me:

  • Use a long needle, 1/2" (12mm) works very well for me. This insures penetration into muscle tissue, which is the whole point of IM. These are the syringes I use, $3.29 a pack of ten from Walgreens:

  • If you pump, use an alternative means to track IOB, unless your pump allows entry of insulin not delivered by the pump (I don't think any do, which is one of those very needed future features). Holger's Glucosurfer is an excellent, fully functional app, if you have an Android smartphone.

    In any case, it's important you keep track of insulin outside your pump delivery. When I do this, I track all insulin (injected for pump delivered) with Glucosurfer, and ignore the pump's IOB calculations until I've fully cleared on glucosurfer (zero IOB). Then, I go back to letting the pump track and manage IOB, and stop entering anything into Glucosurfer.

  • Best locations to inject for me: Deltoid, and thigh. For the thigh, make sure you find a spot with thin sub-q fat -- usually lower on the thigh.
  • If you can, get mildly active for 15-30 minutes after the injection. Nothing rigorous, just enough to get the heart rate up a bit (100-120 bpm). This makes a DRAMATIC difference, for me at least, in how much faster the insulin acts. Muscle has some of the highest perfusion in the body, so a lot of blood will flow through when the hearts pumping.

Other tips? Please share!