Prior to opening insulin vials or pens, patients should store insulin in the refrigerator (2°C to 8°C or 36°F to 46°F).  Once opened, vials and pens can be stored at room temperature (15°C to 30°C or 59°F to 86°F) for approximately one month, or longer. Levemir (42 days), Toujeo (56 days), and Tresiba (56 days) have the longest stability at room temperature. It is important to ask your dispensing pharmacist how long your specific insulin can remain at room temperature.  Always remember to avoid extremes of temperature (too hot or too cold).

Prior to opening, patients can store GLP-1 receptor agonist pens in the refrigerator.  After initial use, patients can store at room temperature for up to 14 days (lixisenatide, dulaglutide), 28 days (exenatide ER), 30 days (liraglutide, exenatide), or 56 days (semaglutide).  

Remember to use a new needle for each injection.  After first use, you can store the insulin pen at room temperature until expired (approximately 1 month after opening).  Remember to rotate injection sites every few days.

Remember to remove any large bubbles by tapping against the syringe before injecting to be sure that you receive the full dose.  Use a new syringe for each injection.  Remember to rotate injection sites every few days.

Most patients prefer to inject in the stomach (2 inches from the navel); however, you can also inject  the top, outer thighs and outer, upper arms.  Remember to rotate injection sites every few days!

Pen needles vary in needle length and needle gauge.  In addition to length and gauge, insulin syringes also vary in volume of insulin held.  For most patients, shorter needle lengths (Example: 4mm or 5/32”) are preferred over longer needle lengths (Example” 12.7mm or 1/2”) for comfort and reducing the risk of injecting into the muscle.  Needle gauge describes the “thinness” of the needle.  Higher gauge values (Example: 32G) represent a thinner needle than a lower gauge (Example: 29G).  Higher gauge needles are generally more comfortable than lower gauge needles.  For accuracy of dosing, it is important to choose a syringe volume closest to the volume administered with each injection.  (Example: Patients requiring small volumes of insulin may benefit from a 30-unit (3/10 mL) syringe; however, patients administering a higher volume of insulin may need a 100-unit (1 mL) syringe to avoid  requiring multiple injections to administer a single dose.)

If you have trouble affording your medications, talk to your pharmacist or provider about your concerns.  Contact your insurance to be sure that the medications are preferred on your insurance formulary (a list of medicines that are preferentially covered by your insurance).  Discuss any alternative options with your provider.  You may be eligible for specific programs that help with the cost of your medicines.  Remember:  never discontinue or “take a break” from medicines without first discussing with your healthcare team.

It is important to know your specific state’s requirements for safe needle disposal.  Recommendations for Maryland include putting used needles in a strong plastic container and putting the plastic container in the trash (not recycled).  Some states (Example: Oregon and Massachusetts) require use of specific plastic containers or certain disposal locations.  Check out safeneedledisposal.org for information regarding your state’s requirements for disposal.

Ask your diabetes provider about using the shortest and thinnest available needles.  Remember to use a new needle each time.  Consider waiting until your insulin reaches room temperature to inject.  If you are using a large volume of insulin, ask your provider if you are a candidate for concentrated insulin to reduce the volume of each injection.