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Posted by on Feb 20, 2015 in blog, Diabetes | 0 comments

Insulin administration

Insulin administration

 

Insulin is the most important drug for diabetics, especially for those suffering from Type 1 diabetes, wherein the body does not produce enough insulin for its functions. Such patients are insulin dependent for a lifetime. And will need to be administered the drug into their bodies in various forms. In those suffering from Type 2, the dependence on insulin increases gradually and insulin in some form is required as a supplement. Available in rapid, short (which is the regular insulin), intermediate and  ongacting types, insulin is either injected separately or mixed in the same syringe. Besides the conventional form of insulin administration- like via Insulin administration the syringe, or a pen with a needle insulin pumps are also available. In the harmacies, insulin is available in concentrations of 40 or 100 units/ml, and the latter is used in patients who are resistant to insulin and hence require very large doses of the drug. Though insulin doses are formulated depending on individual requirements, in infants the doses are prepared separately. The doses should neither be diluted nor altered without the doctor’s prescription and it should be administered with the proper vehicle chosen, whether a syringe, pen or pump. Practically all insulins now-a days are human in origin and ‘analogues’ have come which mimic the insulin action in body in a more efficient way.

Various methods of administrating insulin

Via an Injection

  • Insulin injection through a syringe is given into the deeper layers of the skin (in the subcutaneous tissue), by making a two-finger pinch of skin at a 45–90° angle. However, the skin is not pinched in the case of administering the insulin IM.
  • Length of the needle should be long enough to just pass through the dermis into the fact layer but not enough to reach the muscles.
  • All contents of the vial of insulin should be mixed thoroughly before administering
  • While using syringes, prefer plastic ones than the glass ones.
  • However, in case of using plastic syringes, their reuse should be done carefully as hygiene and maintaining an infection free environment is crucial.
  • The syringes should be graded in accordance with the insulin dosage to ensure administering the correct dosage.
  • Discarding these syringes properly is important and should be done along with the waste disposal of the house.
  • Children who are insulin dependent should be aided by their parents in injecting insulin till they attain the age of 12 years. In some case, it can be continued a little further till 15 years too.
  • Never share a syringe with another user.

Via a Pen

Devices with pen injectors carry insulin in cartridges that have been pre-filled with insulin. Unlike the injection or syringe, in pens, one doesn’t have to fill up the drug from the insulin vial. The pen devices are effective in the case of kids who can’t judge their doses themselves and need to administer the drug when outside the home.

  • Pen devices, though more expensive than injections and syringes, are known to cause lesser pain since these are smaller in size.
  • However, pens may not be as easily available as the injections.
  • Pens can be used more than once without running the risk of an infection, unlike syringes.
  • Yet, pens demand more care while administering. Ensure that there is no air trapped inside or blockage in its needle. It is advisable to wait for 5–10 seconds after pushing the plunger to ensure that all the insulin is removed via the needle.

Via an Insulin Pump

Also called, continuous subcutaneous insulin infusion therapy, the insulin pump comprises of a pump, a disposable reservoir inside the pump that contains insulin, a disposable infusion set, a cannula for inserting under the skin and a tubing system to connect the
insulin reservoir to the cannula.

The pump has the following advantages:

  • An insulin pump is effective in cases of heavy insulin dependence which requires intensive administering of the drug.
  • Since pumps use rapid acting insulin, these offer comfort from following a strict exercise and eating plan, which is needed to control blood sugar with slow-acting insulin.
  • Pumps allow precision in administering the correct amounts of insulin as compared to syringes and pens.
  • Through a pump, insulin can be delivered inside the body at various stages of the day, thereby allowing the body to distribute
  • insulin equally throughout the day thus preventing hypoglycemia, especially during the early morning hours.
  • Even though the pumps are far more expensive, people using the pumps report an improved quality of life.
  • Diabetic ketoacidosis may be caused due to pump failure, especially if the patient is not aware of the functioning and fails to recognize warning signs.

Insulin-overdose, proper injection and weight gain

In case of an overdose of insulin

Well, by now, you know that insulin is a hormone produced by pancreas, an elongated gland behind your stomach. Insulin instrumental for metabolism of sugar derived from carbohydrates, is much required by the body. A person has Type 1 diabetes when the insulin produced by pancreas is lesser than what is required. In Type 2 diabetes, the body stops responding to action elicited by insulin. Both the aforementioned situations result in an increase in the blood sugar levels since the cells are
unable to utilize the sugar available in the body. So, in such a case, insulin has to be administered from external sources for controlling the blood sugar levels. What if the person suffering from diabetes takes an overdose of insulin?

Symptoms of insulin overdose

Insulin overdose may occur either when the patient takes too much of insulin or when enough food has not been consumed for insulin to act on. Given the fact that insulin overdose is not unheard of, you must exercise proper caution and should be able to identify the symptoms of an insulin overdose. These include:

  •  The first and the foremost condition and symptom is that of hypoglycemia, a state of extremely low blood sugar.
  • Seizures
  • Loss of consciousness and ultimately the person going into a diabetic coma.
  • Dizziness
  • Sweating
  • Body going into a state of vigorous shaking or tremors
  • Dryness of tongue, difficulty in speech and coordinating the body movements
  • Anxiety
  • Blurring of vision
  • Extreme hunger bouts and cravings
  • Irregular heart rhythms
  • Uneasiness in chest

Injecting insulin, the right way
Insulin is an integral part of ‘living with diabetes’. Every person with diabetes should be aware of how to properly inject the insulin
using following steps:

  • Insulin has to be kept in a refrigerator. Ensure that you discard the left over insulin in the bottle opened after a period of 30 days since it becomes ineffective thereafter.
  • Before the injection time, keep your syringe, insulin bottle and an alcohol dipped cotton wipe (to clean the mouth of bottle and injection site), ready with you. Sterilize your hands after washing with soap solution and pat drying.
  • Before injecting the insulin, gently roll the bottle between your palms to warm and mix it. Handle it carefully.
  • Take the needle cap carefully off the syringe so that its tip is not damaged.
  • Pull the nozzle of the syringe and draw air upto the same number of units that your insulin dosage would be. Slowly push the nozzle or the plunger back while you insert the needle into the insulin bottle. Turn the bottle upside down while holding the needle at the same place deep into the insulin. Fill the syringe with insulin more than you require by pulling the plunger back.
  • Remove the air bubble, if any, in the     syringe by gently tapping it with your fingernail. Adjust the insulin quantity
  • thereafter as per your requirement.
  • Finally pull out the needle from the insulin bottle.
  • Keep on changing the site for injecting insulin.

Insulin and weight gain
One of the major and quite unwanted side effects of insulin is the weight gain. But there are, of course, ways to prevent the same. The prime reason for weight gain is that in the absence of insulin as it happens in diabetes, glucose is removed from the body through urine since the body is unable to use the same. The moment, we start taking insulin, body starts storing the glucose as fat. While earlier you could consume more calories, the same when consumed now, will be stored as fat. Another reason associated with weight gain is that insulin can result in low blood sugar levels or hypoglycemia.

Persons who have undergone hypoglycemic episodes are scared to undergo the same again and as such indulge in overeating and gain weight in the process of doing so. Interestingly, the myth associated with ‘insulin will take care of all the extra calories you are pumping in’, also leads to weight gain.

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