Insulin
- Insulin is produced by the pancreas’ beta cells. Insulin acts on receptors of the liver, skeletal muscle, and adipose tissue to use/store blood glucose from food.
- Type 1 Diabetes – immune system stops the production of insulin by damaging and destroying the pancreas’ beta cells resulting in uncontrolled blood sugars within the individual
- Type 2 Diabetes – an individual’s body becomes resistant to insulin and the pancreas’ ability to produce insulin decreases resulting in worsening blood glucose levels
- Insulin preparations help to supplement a person’s ability to manage their blood sugars effectively
- Insulin comes in a variety formulations and regimens. Depending on sugar control, you may need one or more of these formulations
- Basal insulin – mimics the body’s ability to release insulin throughout the day
- Bolus insulin – mimics the body’s ability to release insulin when you take in food
- Formulations of insulin
- Rapid Acting (Bolus)
- Given 15-30 minutes prior to a meal
- Takes effect within 10-30 minutes of administration
- Duration of action 3-6 hours
- Must be taken with a meal or it will cause hypoglycemia (low blood sugar)
- Long-acting insulin (Basal)
- Given once to twice daily
- Takes effect within 2-4 hours
- Duration of action 20-24 hours
- Rapid Acting (Bolus)
- Self-administration of insulin requires the use of an insulin pen. A needle is attached to the end of this pen which punctures the skin and allows the insulin to be injected into the fat tissue of the skin.
- The needles come in a variety of sizes to accommodate the body type of the patient.
- Gauge – refers to the thickness of the needle. The higher the gauge the thinner the needle which is preferable for individuals who are more sensitive to the prick of inserting the needle.
- Length – needles come in different lengths. If an individual has less fat tissue, then a shorter needle would be preferable to hit the subcutaneous tissue layer.
- To ensure the needle is attached appropriately and the medication is flowing properly through the needle, the device must be primed. This encompasses wasting a small amount of insulin to clear air from the needle and device and to ensure no administration issues occur.
- When administering the insulin, you should hold the needle in place for 10 seconds to ensure no leakage of the medication occurs when withdrawing the needle
- The needle should be removed after each use and discarded in a sharps container provided to you by your local health center. Do not store your pen with the needle attached as the medication may leak out.
- A glucometer, testing strips, and lancets are necessary for monitoring your blood sugars
- Lancets – puncture the skin of your skin to provide a blood sample which will contain your bodies current blood sugar level
- Testing strips – the blood sample is placed on the specified portion of the strip and is inputted into the glucometer to return a blood sugar reading. Ensure that you have a test strip that is compatible with your glucometer
- Glucometer – there are various types of glucometers. Some provide a larger screen for those with vision problems. Some are more compact so that they are easy to transport. Some machines will come with memory options and extra features like a buzzer or warning. You should consult your healthcare professional about the device.
- Injection sites include the abdomen, upper arms, thighs, and buttocks
- Ensure that the injection is given at a 90-degree angle in order to hit the subcutaneous tissue
- Lipodystrophy – the formation of lumps in the skin can occur with repeat injections to the same spot. Therefore, rotation of the injection site is necessary to prevent this and optimize absorption of the insulin.
- For most people using the 4-6mm needles are sufficient to administer the dose of insulin
- If an individual is extremely thin, the skin can be pinched so that the skin is raised and the insulin can be injected here
