Using and Managing Insulin
All people with type 1 diabetes, and some people with type 2, need to take insulin to help control their blood sugar levels. Type 1 diabetes means your body doesn't make any insulin. Type 2 diabetes means your body either doesn’t make enough insulin or doesn’t use it properly.
Information about the different types of insulin can be accessed by following this link to the Diabetes UK website.
The goal of taking insulin is to keep your blood sugar level in a normal range as much as possible so you’ll stay healthy. Over time, high blood sugar levels can cause serious health problems such as blindness and kidney failure. Some of the drugs taken in type 2 diabetes helps to enhance the action of your own insulin and therefore makes your blood sugar better regulated.
Where should I store my insulin?
- Injecting cold insulin can be uncomfortable and can delay absorption so it is advisable to keep your pen device at room temperature
- Insulin can remain out of a refrigerator for 28 days
- Spare insulin cartridges and vials should be kept in a refrigerator, away from the ice compartment. In the door is ideal
- Insulin should NOT be frozen
- Do not leave the pen/insulin in direct sunlight, in cars or by radiators etc.as this will destroy the insulin
Administering Insulin
Before dialling or drawing up 'cloudy' insulin it is very important to ensure that the insulin is thoroughly mixed. Inverting the pen or vial about 20 times is recommended. Inadequate mixing has been linked to poorer absorption but vigorous shaking of the insulin is not recommended.
Mixed and intermediate insulin should be uniformly cloudy after mixing, if not – discard. This does not apply to any insulins that are CLEAR.
It is important to prime the pen when changing the needle, or th cartridge, or if you can see air bubbles in the cartridge. You 'prime' your pen by holding it vertically with the needle end uppermost, dial 4 units and then 'delivering' the insulin into the air. This is often called an 'air shot'. Note that air injected via this method of injection will not do harm to you.....but will replace some of your insulin dose!
If you notice any fluid leaking from the insulin cartridge - then do not use....the glass may be cracked.
Injections
Insulin needs to be injected into the fat under the skin ·
As people have different amounts of fat the needles come in various sizes
It is important not to inject insulin into the underlying muscle as this can lead to:-
- faster absorption rates
- shorter duration of activity
- higher day to day variation in absorption In some areas therefore it will be necessary to lift (pinch up) the skin while injecting, to avoid the risk of injecting into muscle.
For many years people have reused needles without any obvious problems occurring. However the modern needles are much finer and research has shown that repeated injections can microscopically damage the needle tip and that re-use of needles has been associated with an increased risk of injection site problems. Re-use of needles therefore may be an unnecessary risk.
Do not reuse the needles if they are bent, blunted or contaminated.
Where to Inject
Insulin needs to be injected into the layer of fat beneath the skin.There are 4 main areas for injections:
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abdomen
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thighs
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buttocks
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arms
Insulin is absorbed from these areas at different rates. It is absorbed fastest from the abdomen, followed by arms and thighs, absorption from the buttocks tends to take longer.
In order to predict reliability it is usually better not to mix areas and time i.e. If you use two areas, use one for morning injections and the other for evening injections.
You do not have to change areas but:
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It is very important to rotate the site of your injections each time you inject
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Injecting into the same site can lead to changes in the fat that can cause unsightly lumps and can reduce the absorption of insulin.
Length of Needles
The basic principle of needle length is that it should enter the layer of fat underneath the skin. If the needle is too long, the insulin may be injected into muscle, which will cause absorption problems. If in doubt lift up the injection area and gauge this with the length of your needle.
Injection Technique
Insulin should be injected at a 90° angle to the skin.
The needles are very sharp and fine and can be inserted without a stabbing technique
It is generally a painless procedure
Continue to lift skin whilst injecting
When the injection is complete the needle should remain in position for about 10 seconds to allow for complete administration of the insulin
Bruising and bleeding can occur, particularly if people are on aspirin or warfarin. Sometimes it is due to injection technique. This does not affect the action of insulin.