Know about insulin therapy

Getting Ready

  • Know the name and dose of each medicine to give. The type of insulin should match the type of syringe: U-40 or U-100.
  • Some types of insulin can be mixed with each other in one syringe — but not all. Consult with your health care provider or pharmacist about this.
  • Always use the same brands and types of supplies. Do not use expired insulin.
  • Insulin should be at room temperature. If you had it in the refrigerator or cooler bag, take it out 30 minutes before the injection.
  • Gather your supplies: insulin, needles, syringes, alcohol wipes, and a container for used needles and syringes.

Filling the Syringe – One Type of Insulin

  • Wash your hands with soap and water. Dry them well.
  • Check the insulin bottle label. Make sure it is the right insulin. Make sure it is not expired.
  • The insulin should not have any clumps on the sides of the bottle. If it does, throw it out and get another bottle.
  • Intermediate-acting insulin is cloudy, and must be rolled between your hands to mix it. Do not shake the bottle. This can make the insulin clump.
  • Clear insulin does not need to be mixed.
  • If the insulin vial has a plastic cover, take it off. Wipe the top of the bottle with an alcohol wipe. Let it dry. Do not blow on it.
  • Know the dose of insulin you want. Take the cap off the needle, being careful not to touch the needle to keep it sterile. Pull back the plunger of the syringe to put as much air in the syringe as the dose of medicine you want.
  • Put the needle into and through the rubber top of the insulin bottle. Push the plunger so the air goes into the bottle.
  • Keep the needle in the bottle and turn the bottle upside down.
  • With the tip of the needle in the liquid, pull back on the plunger to get the right dose of insulin into the syringe.
  • Check the syringe for air bubbles. If there are bubbles, hold both the bottle and syringe in one hand, and tap the syringe with your other hand. The bubbles will float to the top. Push the bubbles back into the insulin bottle, then pull back to get the right dose.
  • When there are no bubbles, take the syringe out of the bottle. Put the syringe down carefully so the needle does not touch anything.

 

Filling the Syringe – Two Types of Insulin

  • Never mix two types of insulin in one syringe unless you are told to do this. You will also be told which insulin to draw up first. Always do it in that order.
  • Your doctor will tell you how much of each insulin you will need. Add these two numbers together. This is the amount of insulin you should have in the syringe before injecting it.
  • Wash your hands with soap and water. Dry them well.
  • Check the insulin bottle label. Make sure it is the right insulin.
  • The insulin should not have any clumps on the sides of the bottle. If it does, throw it out and get another bottle.
  • Intermediate-acting insulin is cloudy, and must be rolled between your hands to mix it. Do not shake the bottle. This can make the insulin clump.
  • Clear insulin does not need to be mixed.
  • If the vial has a plastic cover, take it off. Wipe the top of the bottle with an alcohol wipe. Let it dry. Do not blow on it.
  • Know the dose of each insulin you want. Take the cap off the needle, being careful not to touch the needle to keep it sterile. Pull back the plunger of the syringe to put as much air in the syringe as the dose of the longer-acting insulin.
  • Put the needle into the rubber top of that insulin bottle. Push the plunger so the air goes into the bottle. Remove the needle from the bottle.
  • Put the air in the short-acting insulin bottle the same way as the previous two steps above.
  • Keep the needle in the short-acting bottle and turn the bottle upside down.
  • With the tip of the needle in the liquid, pull back on the plunger to get the right dose of insulin into the syringe.
  • Check the syringe for air bubbles. If there are bubbles, hold both the bottle and syringe in one hand, and tap the syringe with your other hand. The bubbles will float to the top. Push the bubbles back into the insulin bottle, then pull back to get the right dose.
  • When there are no bubbles, take the syringe out of the bottle. Look at it again to make sure you have the right dose.
  • Put the needle into the rubber top of the longer-acting insulin bottle.
  • Turn the bottle upside down. With the tip of the needle in the liquid, slowly pull back on the plunger to exactly the right dose of long-acting insulin. Do not draw extra insulin in the syringe, since you should not push the mixed insulin back into the bottle.
  • Check the syringe for air bubbles. If there are bubbles, hold both the bottle and syringe in one hand, and tap the syringe with your other hand. The bubbles will float to the top. Remove the needle from the bottle before you push out the air.
  • Make sure you have the right total dose of insulin. Put the syringe down carefully so the needle does not touch anything.

 

 

Giving the Injection

Choose where to give the injection. Keep a chart of places you’ve used, so you don’t put the insulin in the same place all the time. Ask your doctor for a chart.

  • Keep your shots 1 inch away from scars and 2 inches away from your navel.
  • Do not put a shot in a spot that is bruised, swollen, or tender.

The site you choose for the injection should be clean and dry. If your skin is visibly dirty, clean it with soap and water. Do not use an alcohol wipe on your injection site.

The insulin needs to go into the fat layer under the skin.

  • Pinch the skin and put the needle in at a 45º angle.
  • If your tissues are thick enough, you may be able to inject straight up and down (90º angle). Check with your health care provider before doing this.
  • Push the needle all the way into the skin. Let go of the pinched skin. Inject the insulin slowly and steadily until it is all in.
  • Leave the syringe in place for 5 seconds after injecting.

Pull the needle out at the same angle it went in. Put the syringe down. There is no need to recap it. If insulin tends to leak from your injection site, press the injection site for a few seconds after the injection. If this happens often, check with your health care provider.

Place the needle and syringe in a safe hard container. Close the container, and keep it safely away from children and animals. Never reuse needles or syringes.

Site Rotation

The place on your body where you inject insulin affects your blood glucose level. Insulin enters the blood at different speeds when injected at different sites. Insulin shots work fastest when given in the abdomen. Insulin arrives in the blood a little more slowly from the upper arms and even more slowly from the thighs and buttocks.

Don’t inject the insulin in exactly the same place each time, but move around the same area. Each mealtime injection of insulin should be given in the same general area for best results. For example, giving your before-breakfast insulin injection in the abdomen and your before-supper insulin injection in the leg each day give more similar blood glucose results. If you inject insulin near the same place each time, hard lumps or extra fatty deposits may develop. Both of these problems are unsightly and make the insulin action less reliable. Ask your health care provider if you aren’t sure where to inject your insulin.

 

 

Timing

Insulin shots are most effective when you take them so that insulin goes to work when glucose from your food starts to enter your blood. For example, regular insulin works best if you take it 30 minutes before you eat.

Insulin Storage and Syringe Safety

  • Store current bottle of insulin at room temperature to avoid painful injections, but keep extra supplies in the refrigerator.
  • Syringes can be reused safely, but it must be done carefully to avoid contamination.
  • Dispose of syringes in containers that prevent the needles from causing harm and check medical waste requirements for your area.
  • Examine the bottle closely to make sure the insulin looks normal before you draw the insulin into the syringe.
  • Do not store your insulin near extreme heat or extreme cold.
  • Never store insulin in the freezer, direct sunlight, or in the glove compartment of a car.
  • Check the expiration date before using, and don’t use any insulin beyond its expiration date.

Syringe Reuse

  • Keep the needle clean by keeping it capped when you’re not using it.
  • Never let the needle touch anything but clean skin and the top of the insulin bottle.
  • Never let anyone use a syringe you’ve already used, and don’t use anyone else’s syringe.
  • Cleaning it with alcohol removes the coating that helps the needle slide into the skin easily.

Syringe Disposal

  • Dispose of an insulin syringe when the needle is dull or bent or has come in contact with anything other than clean skin.
  • Clip the needles off the syringes so no one can use them. It’s best to buy a device that clips, catches, and contains the needle. Do not use scissors to clip off needles — the flying needle could hurt someone or become lost.
  • If you don’t destroy your needles, recap them. Place the needle or entire syringe in an opaque (not clear) heavy-duty plastic bottle with a screw cap or a plastic or metal box that closes firmly.
  • Do not use a container that will allow the needle to break through, and do not recycle your syringe container.

 

 

 

 

 

Storage of insulin

Store insulin properly. Insulin that’s improperly stored or past its expiration date may not be effective.

Although it is recommend that insulin should be stored in the refrigerator, injecting cold insulin can sometimes make the injection more painful. To avoid this, you can keep the bottle of insulin you are using at room temperature. Insulin kept at room temperature will last approximately 1 month. Unused insulin should be kept at refrigerator.

Do not store your insulin near extreme heat or extreme cold.

Never store insulin in the freezer or direct sunlight.

If you use regular, check for particles or discoloration of the insulin. If you use NPH or mixed, check for “frosting” or crystals in the insulin on the inside of the bottle or for small particles or clumps in the insulin. If you find any of these in your insulin, do not use it, and return the unopened bottle to the pharmacy .

 

 

Syringe Reuse

 

Reusing syringes may help you cut costs, avoid buying large supplies of syringes, and reduce waste. However, talk with your doctor or nurse before you begin reusing.

 

Do not reuse if-

 

You are ill,

You have open wounds on your hands, or

You have poor resistance to infection.

 

Here are some tips to keep in mind when reusing syringes:

 

  • Keep the needle clean by keeping it capped when you’re not using it.
  • Never let the needle touch anything but clean skin and the top of the insulin bottle.
  • Never let anyone use a syringe you’ve already used, and don’t use anyone else’s syringe.

 

Do not do this to your syringe

 

  • Cleaning with alcohol swab. This removes the coating that helps the needle slide into the skin easily and makes injection painful.