The following information is intended for healthcare professionals only

Many healthcare professionals manage injection or infusion therapies in patients with diabetes. Until now, few published guidelines have been available to help health professionals and their patients effectively manage these therapies.

The ‘Golden Rules of Injection Technique’ are based on the outcomes of FITTER (Forum for Injection Technique & Therapy Recommendations)*, an international workshop sponsored by BD.1 FITTER brought together over 180 diabetes experts from 54 countries to review the latest clinical evidence, diabetes management practices and analyse the results of the largest-ever global survey on injection technique, which consisted of 13,289 respondents from 42 countries.2,3 The Golden Rules of Injection Technique have been developed to assist healthcare professionals to help optimise diabetes treatment outcomes.

The Golden Rules detail recommendations for injection technique, treating and preventing lipohypertrophy**, managing psychological issues regarding medication delivery, and infusion.4

The following information is intended for healthcare professionals only 

Injection Technique in Adults

Injection Technique in Children

Treating and Preventing Lipohypertrophy

Psychological Issues around Insulin Delivery

Needlestick injuries and Sharps disposal

Insulin Infusion


In May 2017, the first-ever Australian and New Zealand Forum for Injection Technique & Therapy Expert Recommendations (FITTER) was held in Sydney. The event focused on the increasing need for effective collaboration among all healthcare specialties and the importance of frequent and consistent communication with self-injecting patients to optimise treatment outcomes. To view the event webinar, click here.

* The FITTER Workshop was held in Rome, Italy in October 2015.

** Lipohypertrophy (Lipo) is thickened skin or rubbery lumps and bumps that can build up in the fatty layer under the skin at injection sites. Lipo is the result of needle re-use and repeated trauma to the same injection site when injectionsites are not rotated correctly. 4

  1. Frid AH, Kreugel G, Grassi G et al. Mayo Clin Proc. September 2016:91(9):1231-1255.
  2. Frid AH, Hirsch LJ, Menchior AR et al. Mayo Clin Proc. September 2016:91(9):1224-1230.
  3. Frid AH, Hirsch LJ, Menchior AR et al. Mayo Clin Proc. September 2016:91(9):1212-1223.
  4. Blanco M, Hernandez M, Strauss K, Amaya M et al. Diabetes Metab. 2013; 39(5):445-53.