Introduction of insulin with a syringe-pen

Insulin is administered subcutaneously, and sometimes( in case of emergency) by intramuscular or intravenous route. The subcutaneous route of administration is not physiological, but now it is the only acceptable method of continuous insulin therapy. The patient must know about the factors that affect the volume, as well as the rate of absorption into the blood of insulin after its administration. It should be borne in mind that insulin is unique as a medicine in that the effectiveness of the drug is not only dependent on its characteristics, but also on many conditions, for example, related to the technique of administration, etc.

Where to introduce insulin?

The effect of insulin is influenced by the site of administration. For example, with subcutaneous injection into the abdomen( right and left of the navel) insulin is absorbed most quickly, and when injected into the thigh - slowly and not completely( 25% less).The introduction of insulin into the shoulder or buttocks is more effective than the introduction to the thigh, but less effective than the injection into the stomach. Thus., When changing the place of the injection, significant fluctuations in the effect of insulin action, especially short-acting insulin, are possible. This is why all the zones of insulin administration( abdomen, shoulder and thigh) need to consistently alternate according to a certain scheme. For example, in the morning you can always perform injections in the stomach, at lunchtime - in the shoulder, and in the evening - in the thigh. Also, you can always perform injections in the stomach.

An injection of a short-acting insulin pen is most expedient to conduct in the stomach, and long-acting insulin - into the hip or shoulder. When insulin is injected into the same area of ​​the skin over a long period, changes occur in the subcutaneous fatty tissue. This slows the absorption of insulin. In view of this, the effectiveness of insulin action is markedly reduced, which can lead to a false conclusion about the need to increase the applied doses. This can be prevented by the constant change of injection sites and the observance of distances between several places of insulin administration.

Also, the rate of absorption of insulin has a dependence on skin temperature at the site of injection. For example, a bath, a hot shower, or applying a warmer, being under a hot sun increase the degree of absorption of insulin, sometimes even twice. On the contrary, cooling the skin helps to slow the absorption of the drug almost in half. It is not recommended to introduce insulin, which was recently taken out of the refrigerator. The drug solution should be at room temperature.

If you are using injection site massage, then increases insulin absorption by 30%.Therefore, a small massage of the injection site after the introduction of insulin should either be carried out constantly, or not carried out at all. In some cases( for example, during celebrations with a large meal), you can accelerate the absorption of insulin if you massage the injection site.

Physical activity increases the degree of insulin absorption regardless of the site of injection and the nature of physical activity. Recommendations to change the injection site before muscular work in order to prevent hypoglycemia are ineffective, since the main glucose-lowering effect is muscular load. But one can not ignore the fact that insulin absorption from the area of ​​actively working muscles is more intense, therefore, the level of insulin in the blood will be stronger when injecting into more active parts of the body.

The introduction of insulin with a syringe-handle should be sufficient deep. Specially trained patients can inject short-acting drugs intramuscularly for signs of diabetic ketoacidosis or before taking fast-digested carbohydrates. Intramuscular administration of long-acting insulin is not recommended due to their short glucose-lowering effect. With a shallow intradermal injection, insulin is not absorbed enough, and soreness and redness occur at the site of the injection.

The duration of exposure to insulin increases proportionally with the increase of the administered single dose.

Kind of syringe.

You can use insulin syringes for injections, including plastic ones. A standard syringe is calculated per dose in 1 ml of insulin( 40 U).If the hygiene rules are followed, reuse of plastic insulin syringes is possible within 2 to 3 days. To do this, just close the needle cap and then store it in this form without carrying out sterilization measures. But after 4 to 5 injections due to dulling the needle, injections will become painful. That is why when carrying out intensive insulin therapy syringes for injections should be used once. Before the injection should be thoroughly wiped with cotton wool soaked in alcohol solution, the rubber stopper bottle. Vials with a short-acting insulin content should not be shaken. Usual insulins having delayed action are suspensions, ie, a sediment forms in the vial, which must be thoroughly shaken before taking insulin.

When the insulin is collected in the syringe, the piston must be pulled back to the mark that indicates the desired number of insulin units. After that, need to pierce the rubber plug of the vial with the medicine, press the piston and let the air into the vial. The syringe with the vial is then turned upside down, keeping them at the eye level with one hand and pulling the piston down to a slightly higher level than the necessary dose of insulin. It is very convenient to carry out the introduction of insulin with a syringe-pen.

If necessary, by certain rules, mix several insulin in one syringe. At the same time, an insulin of short action, then of long duration, is injected into the syringe. In the case of mixing fast and long-term insulin, the action of fast ones does not slow down. Sometimes a slowdown is possible in case of mixing fast and NPH-insulin.

With the introduction of insulin, certain techniques must be followed. Place the injection should be wiped with warm water using soap. Alcohol wipe the site of the injection should not be, because alcohol dries the skin. If alcohol is still used, it should evaporate from the skin before the injection.