A patient with diabetes is learning about insulin administration. Which statement by the patient indicates the need for further teaching?

Rationale: A. Rotating insulin injection sites prevents lipodystrophy, which can appear as localized thickening or loss of subcutaneous fat. Lipodystrophy can alter insulin absorption and lead to unpredictable blood glucose levels. Systematically rotating sites such as the abdomen, thighs, upper arms, and buttocks ensures consistent absorption and reduces tissue damage. B. Administering insulin before meals helps control postprandial glucose spikes. Rapid-acting insulin is usually given 15–30 minutes before a meal, and short-acting insulin about 30–45 minutes prior. Proper timing prevents hyperglycemia and late post-meal hypoglycemia, reflecting knowledge of effective glycemic management. C. Injecting insulin through clothing is unsafe. This practice can result in needle bending or breakage, inaccurate dosing, increased risk of infection, and skin irritation. Patients should always inject into clean, exposed skin using the proper needle length and angle to ensure safety and effective insulin absorption. This statement indicates the need for further teaching. D. Monitoring for hypoglycemia is essential after insulin administration. Early recognition of symptoms such as shakiness, sweating, pallor, confusion, palpitations, or irritability allows timely intervention with fast-acting carbohydrates. This demonstrates safe self-management practices and awareness of potential complications.