IM Injections Over Sub Q Shots/ or Pump Boluses

Eric got me into doing IM injections. first i must say that it requires a syringe long enough to hit the muscle and go deeper that the tiny length of a regular sub q shot. i have found that 8mm is perfect for this.there are different parts of the body (as YDMY) that are very efficient locations to give yourself the injection. I use my upper thigh muscle, as it is very lean, and when i flex this muscle, it is a breeze to hit. after taking the shot, i exercise the muscle a bit, flexing it slightly for about a minute or two.

now, whats terribly important is learning what you ISF is with the IM injection. when i was first trying the first shot out to correct a high BG, i used my regular ISF ( 1 unit brings me down approximately 50 points.) so i used the same mathematics for gaging the injection. i filled up the barrel, and stuck the needle right into my thigh.

within one hour, my BG had come down from over 200 to 125. sweet :blush: what i didn’t count on was that the insulin was still in my body for 3 more hours, and what happened was that i ended up crashing. (duh; i hadn’t counted on this.)

i thought that the best way to know how much active IOB i had in my body at any particular time, was to program it into my pump, disconnect from my pump, and then have the pump deliver this “phantom” bolus. this way, i could look at my pump and be aware of what was happening in my body at any particular time. i thought that this was pure genius ( IMHO, :wink: ).

so i repeated this a couple of times, but i continued to crash. so after experimenting a number of times, i realized that all i needed was about 1/2 the amount of insulin that i did when i used my pump for a correction. my body just responded differently, absorbing the insulin, perhaps, more efficiently.

so, try this out some time. it is great once you figure it out. it is so nice to know that you, too, can have this kind of immediate control over your blood sugar levels.

leave it to Eric to get me started on one of his crazy suggestions :wink: (got to say, though, that i am so glad i took his info and made it mine !

good luck!


I’m wimpy and it hurts… I’ve tried but then give up and just do sub q when I feel the needle hitting muscle. It still comes down a little faster than my normal ab injections when I try my quad and end up with sub q and I’m running but not by that much. I still have some needle-phobia… I have this irrational fear that the 6mm needle will come out my back (my first 2 weeks, my abs completely shut down due to this and my back was supporting all my posture, it was awful). It hurts, I’m a wimp, but sometimes I really would like to get a high down faster. Any tips for getting it over with or do I just need to suck it up?


You do Tri’s, therefore you are not a wimp.

I bet you are in pain during the running portion of every Tri. What do you do in the final 1600 meters? You suck it up…

I promise you, an IM shot hurts a lot less than a 5k. Not even close!


no, you dont need to “just suck it up” i have been D for so many years and when i was starting out there were none of all these fancy gadgets around like there are now. we just had needles, and they were much bigger and longer than they are now. i used to count : 1,2,3 and jab right into my tushy. i felt like i needed a shot of tequila before giving myself a shot :wink: .

now i am so used to having to change my PUMP infusion site, which i hate, that a little old needle means nothing to me. i guess its something you just get used to. practice practice practice.


DM, this is an outstanding post, so glad you posted this! I am going to have my son read it tonight.


thanks so much M. greatly appreciated. glad to know that i can be helpful :smile:


z[quote=“daisymae, post:4, topic:2207”]
felt like i needed a shot of tequila before giving myself a shot :wink: .

You crack me up, DM!! :joy_cat::joy_cat:


I love IM injections. I put them off for the longest time because I was scared, but once I started using them, they became a great tool. Sometimes I still miss my muscle (I have lots of fat so it’s easy to do!), but when I do hit it, my blood sugar usually comes back down into target range within an hour. I use an IM shot whenever I’m above 10-11 mmol/L or have a stubborn high at a lower level that just won’t come down. I agree that they are less traumatic than inserting pump sites, which I also hate at times.


A post was split to a new topic: Less pain when changing pump site

I did my first IM yesterday, after reading @daisymae’s post. Thanks, @daisymae!

I used an 8mm BG needle on the large part of my thigh (my quad). I flexed my muscle, injected, then ran on it for 5 minutes to speed up the absorption. The effect started right away, in the next 5 minutes (unless it was a coincidence). It did not hurt at all.

I forgot the part where @daisymae said she needed 1/2 less. I ran low too, I should have underdosed the correction. Here is my BG track:


Thanks to my dad for the Clarity data and the pic.


Nice post @daisymae!

I joined the IM Club a couple of days ago when I had a pump site failure. Most of my lunch bolus leaked out without me noticing and I went high @Eric had suggested trying a syringe to load the Omnipod so I had a syringe laying around to try. It was 8mm.

I had not used a syringe in about 20 years but I still have the technique. I used my calf because it is hard not to hit a muscle there.

Like @Kaelan and @daisymae I dropped a little bit too much but I turned my basal off and ate some carbs before I hit the low. Of course I ate too many carbs so I got another roller coaster hill :slight_smile:

Anyways I stopped the very fast rise at 180 (10) and in about 1.5 hr was back to 90 (5). Will have to find the pictures.


One of the things I mentioned to DM, pumps are great for controlling basal, but IM shots are really great for fast absorption - not just for high BG but also for meals.

So in a hybrid application, you could use a pump to handle changing basals for nighttime, daytime, exercise, and also use the pump for meals that are easy. And use IM shots for high BGs and challenging meals. I do that frequently.


I applaud all who are doing or have tried IM injections. I am a guinea pig with pretty much anything else but this. I cannot bring myself to do it.

Awesome post and information thought @daisymae !!!


Mike, it really doesnt hurt at all. the needle is in and out so fast that you dont have time to think about any pain. try it once since you are a guinea pig, and then draw your own conclusions.

one thing i must make clear: be careful with your dosing b/c after many tries, i have found that my ISF is more than 1/2 of what i need for the sub q or pump injections. i need 1 unit to bring me down 50 BGs with my pump or an injection. but, for IM, i need only 1/2 as much. it seems to bring me down much much faster as well as twice as strong ( 1 unit will bring me down between 75 - 100 points.!!! so beware.)


So many things are done IM. Flu shots, tetanus shots, B12 shots. All of those have been given to me IM.

Why should diabetes and insulin be short-changed?! If IM is good enough for those other things, it’s good enough for insulin!

Ha, just joking around with you, but seriously, I am sure you have had plenty of IM shots in your life. It’s really not bad.


and just to add to erics comment, those shots hurt much more than an IM insulin shot; the gage if the needle is much finer b/c insulin is not as thick as the other medicines that they inject IM.


You can call her Dr. DM.
:wink: :heart:


Ha ha ha ha :blush:

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Me, neither. Though we have Afrezza, so…it works pretty quickly to drop a high, too (testing it on my first major high this morning, in fact. Ugh).

I was talking to my husband, who’s a nurse, about IM injections, and he said he’d be worried about potassium imbalance. Apparently, potassium moves back into the cells with insulin therapy (he said they usually administer potassium along with insulin for certain situations in the hospital), so he said with the rapid action of IM insulin, you could end up with too little potassium in your blood? Any thoughts on that?


The reason they use potassium when they do intravenous insulin for people in hospitals is because of the big amounts of insulin they are using. When people go to the hospital for DKA, they are getting a big amount of insulin to bring them down.

As you know, insulin brings glucose into the cells. (No matter how you take it - subcu, IM, IV, or inhaled, all insulin does this). When this happens, potassium follows the glucose into the cells, which decreases the serum potassium level.

But when people are in the emergency room getting intravenous insulin for DKA, they are worried about the large amounts of insulin that is given to bring them down. There is an elevated serum potassium initially when patients are in a state of DKA. But this comes down quickly as insulin is administered and the potassium shifts back into the cells. So they also administer potassium.

For normal amounts of insulin, the amounts you would take for basal and meals and to bring down a high BG, this is not a concern. It’s only when they are pumping it into you in the big doses in the ER that it is a concern.