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Insulin Injection Site Pain

7 Tips To Stop Injection Site Bruising

7 Tips To Stop Injection Site Bruising

Integrated Diabetes Services (IDS) provides detailed advice and coaching on diabetes management from certified diabetes educators and dieticians. In 2015, Insulin Nation will be featuring a regular Q&A column from IDS that answers questions submitted from the Type 1 diabetes community. Q: Is it common to get bruises at the site of injection? What can you do about that? A: There are many reasons that an injection site might develop a bruise. Try some of these techniques to decrease the chances of bruising: Ice the injection site for about 30 to 60 seconds prior to giving the injection.The cold helps to shrink away the capillary blood vessels which may get punctured during a shot. If the bruising happens specifically in your abdomen, make sure you are not injecting too close to your belly button. sponsor Shorter needles tend to cause more bruising than longer needles. If you are on blood thinners like warfarin, aspirin, or Plavix, you may be more at risk for bruising. Discuss this with your healthcare provider. Make sure you are injecting at a 90 degree angle to your skin, and not on a slant. Always use a new needle or pen cap for insulin pens. Reusing needles causes more trauma to the tissue. Switch injection sites. Repeated injection into the same area can cause bruising, as well as the development of scar tissue. Have a Question? Insulin-Quiring Minds is a free service of the clinical team at Integrated Diabetes Services LLC. Submit your questions to [email protected] All questions will be answered, and yours may be chosen to appear in Insulin Nation. About Integrated Diabetes Services Integrated Diabetes Services provides one-on-one education and glucose regulation for people who use insulin. Diabetes “coaching” services are available in-person and Continue reading >>

Selecting The Injection Site

Selecting The Injection Site

Select a safe part of the body where to inject insulin There are four safe areas for insulin injections: the side of the thighs, the back of the upper arms, the abdomen (belly), and the upper outer buttocks. 1. On the thighs, use the top and outer areas only. Do not use the inner side or back of the thigh. Stay about three to four finger-widths away from the knee and groin. 2. On the upper arms, use the fleshy area on the side and back of the arms. Avoid the muscle in the shoulder. Stay three to four finger-widths away from the elbow. 3. On the abdomen, inject in the area right across the abdomen, from just below the ribcage to well below the belt line. Stay about two finger widths away from the belly button. 4. The outer top of the buttocks where the pant belt would sit. Insulin may be absorbed differently from one site to another. Also, insulin injected over an exercising muscle may be absorbed more quickly. For that reason, it is best to rotate and inject insulin into fatty areas in the parts of the body mentioned above. If there is no fat, then rotate injections amongst the other designated injection sites. Injections are done in a pattern to avoid using exactly the same site over and over. Make sure that each injection is about an inch (2.5 cm) or two finger widths from the one done before. Try to work in straight, even rows about an inch apart. This way you are more likely to remember where the last injection was given. Rotating insulin injection sites Many people with diabetes, children especially, develop “favourite” injection sites where there seems to be less pain and injections seem easier. You should always rotate injection sites regardless of how you give the insulin: pen, syringe, or insulin pump. If you use the same small area many times, the fat tiss Continue reading >>

The Importance Of Good Insulin Injection Practices In Diabetes Management

The Importance Of Good Insulin Injection Practices In Diabetes Management

Abstract: Abstract Time constraints are often significant when treating patients with diabetes with insulin. In such settings, focus is often placed on the type of insulin the patient is taking, with an even greater emphasis placed on the amount. However, how much emphasis is placed on the practical aspects of insulin use? Is the patient using proper injection techniques? Are the insulin syringes or pens being cared for correctly? Are needles being quietly re-used without the medical staff’s knowledge? Are sharps being disposed of safely? Diabetes education regarding the proper use of insulin takes much time and effort. Without it, however, the appropriate type of insulin at the correct dose might not necessarily give the intended outcome. Instead, marked glycemic excursions could occur, leaving the goal of good diabetes control unachievable and the medical staff baffled. Keywords Diabetes, insulin, injection technique, insulin pens, insulin syringes, insulin needle re-use, patient education Disclosure: Richard Dolinar, MD, is a member of the speakers’ bureaus of Amylin, Eli Lilly, and Takeda and a consultant for BD Medical and Pfizer. Received: October 22, 2009 Accepted: December 2, 2009 Correspondence: Richard Dolinar, MD, Arizona Endocrinology Center, 5130 W. Thunderbird Road, Suite 1, Phoenix, AZ 85306. E: [email protected] When insulin-requiring patients with diabetes are seen in the clinic,there is usually a great emphasis placed on the type of insulin the patient is taking and an even greater emphasis on the amount. However, how much emphasis is placed on the practical aspects of insulin use? Which technique is the patient using to inject the insulin? Is he or she injecting it correctly? What sites are being used? Are the insulin syringes or pens being ca Continue reading >>

Insulin Pens: How To Give A Shot

Insulin Pens: How To Give A Shot

Many people with diabetes need to take insulin to keep their blood glucose in a good range. This can be scary for some people, especially for the first time. The truth is that insulin shots are not painful as people imagine because the needles are short and thin. Insulin shots are given into fatty tissue below the skin. This is called a subcutaneous (sub-kyu-TAY-nee-us) injection. The following instructions are for using most disposable insulin pens. If you are using a refillable pen, check with your doctor, diabetes educator or pharmacist on how to use. If you prefer to use a vial and syringe, refer to UPMC patient education page Insulin: How to Give a Shot. ADVANTAGES of insulin pens: Easy to use and carry Looks like a pen for writing (discreet/not easily noticed) No need to draw the insulin dose from a vial/bottle Can be used for most insulin types Doses can be easily dialed Less waste of expired insulin if not much insulin is used within time period designated (300 units in each pen)…see table end of this document To some people it may be less scary than a syringe DISADVANTAGES: Cannot mix different kinds of insulin together in a prescribed dose. Before you give the shot, you will need the following: Insulin pen Alcohol swab, or cotton ball moistened with alcohol Pen needle (be sure your doctor writes your prescription for the pen needles as well as the specific type of insulin pen) Hard plastic or metal container with a screw-on or tightly-secured lid Parts of an Insulin Pen Wash your hands. Check the drug label to be sure it is what your doctor prescribed. Check the expiration date on the pen. Do not use a drug that is past the expiration date. Also do not use if beyond number of days listed in table at end of this document once opened and in use. Remove pen cap Continue reading >>

Insulin Injection

Insulin Injection

Insulin injection is used to control blood sugar in people who have type 1 diabetes (condition in which the body does not make insulin and therefore cannot control the amount of sugar in the blood) or in people who have type 2 diabetes (condition in which the blood sugar is too high because the body does not produce or use insulin normally) that cannot be controlled with oral medications alone. Insulin injection is in a class of medications called hormones. Insulin injection is used to take the place of insulin that is normally produced by the body. It works by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. All of the types of insulin that are available work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Insulin comes as a solution (liquid) and a suspension (liquid with particles that will settle on standing) to be injected subcutaneousl Continue reading >>

The Least Painful Insulin Injection Sites: Not Just About Location

The Least Painful Insulin Injection Sites: Not Just About Location

The four most recommended sites for insulin injections were chosen because they share two qualities: They have a generous fat layer just beneath the skin into which the insulin is injected, and they have fewer nerve endings than many other areas of the body. None of the four sites – abdomen, back of the upper arm, upper buttocks, upper/outer thigh – is nerve-free, though, so some injection discomfort is normal. The factors that seem to most influence the pain level of insulin injections are a person’s perception and anticipation of pain, the sharpness and maybe the size of the needle, and injection technique. Needle Sharpness and Size A study published about 20 years ago showed the one factor most responsible for increased injection pain was the bluntness of a needle. The needle diameter and dose size had significantly less effect on an insulin users’ experience of pain. Those who reuse needles are injecting themselves with dulled and possibly bent needles. This can do more than just increase pain; a separate study showed that reuse raises the risk of developing lipohypertrophy, a lumpy buildup of fat under the skin at injection sites. Many people today, children and adults, report less pain when using short, narrow-gauge needles – those typically used in insulin pens (4 to 5 mm x 32G). Insulin pen needles also have the advantage of not being dulled by piercing the membrane of an insulin vial or getting accidentally bent since there is no needle cap to remove. Minimizing the Discomfort Besides using each needle only once, there are other ways to minimize pain at the injection site: Use insulin that is at room temperature. Remove all of the air bubbles from a syringe before injecting. Let the site disinfectant (usually alcohol) dry before injecting. Keep the di Continue reading >>

How To Give Yourself Insulin

How To Give Yourself Insulin

Expert Reviewed Six Methods:Monitoring Your Blood Glucose LevelsGiving Yourself Insulin Using a SyringeUsing a Pen Device to Inject InsulinRotating Your Injection SitesUsing Other Methods to Administer InsulinFollowing Recommended Safety PrecautionsCommunity Q&A Nearly three million people in the United States use insulin to treat either type 1 or type 2 diabetes.[1]. In people with diabetes, the pancreas does not produce enough insulin to manage the carbohydrates, sugars, fats, and proteins in your diet. The use of insulin in people that suffer from type 1 diabetes is an absolute necessity in order to sustain life. Many people with type 2 diabetes often reach a point where medication, diet, and exercise, are not enough to control blood sugar levels, and begin a regimen that includes insulin administration. The correct administration of insulin takes a solid understanding of the type of insulin you are using, your method of administration, and a commitment to follow recommended safety precautions to prevent harm or injury. Consult with your doctor for a thorough demonstration before attempting to administer insulin. Continue reading >>

Why A Change In Location Is Good… For Your Insulin Injections

Why A Change In Location Is Good… For Your Insulin Injections

We all know the health reasons behind changing your lancet and keeping sterile needles for insulin. But why should it matter where on your body you inject? In actuality, where you inject your insulin and how often you inject it there can have some considerable impacts on the rate of insulin absorption and changes in skin texture around the injection site. The best way to avoid complications from over-injecting in the same place is to constantly change where you inject and use a system of injection site rotation. One major motivator for alternating your insulin injection spots is to avoid lipohypertrophy – the accumulation of fat cells under the skin. When the tissue thickens, lumps of fat can form around the injection site and can slow the absorption of insulin into your blood stream by as much as 25%[1]. Another side effect is liposatrophy, where the fat beneath the skin’s surface becomes depleted and can give a dimpled appearance. While these conditions (collectively known as lypodystrophy) are not life threatening, they can result in less stable blood glucose levels since an increase of insulin resistance can occur at the injection site and may require higher doses of insulin over time. Where you inject also matters because different parts of your body intake the insulin differently. The most sensitive and fast absorbing area is your stomach and decreases in the rate of insulin uptake in the arms, then legs, and buttocks. When you are injecting for fast acting or slow release insulin you’ll want to take this into consideration. If you need an insulin dose before you hit the gym or take that evening jog, it is best to avoid injecting in the arm or thigh as the increase in blood flow to these areas can speed up the insulin absorption. Whether you are new to insul Continue reading >>

Getting Up To Speed On New Injection Guidelines (part 2)

Getting Up To Speed On New Injection Guidelines (part 2)

Last week I mentioned that there are new insulin injection guidelines (as of 2010) that came out of a workshop called TITAN. These guidelines are important because they aim to achieve clarity about and consistency in how people with diabetes inject their insulin. Sadly, however, I suspect that not many health-care professionals, let alone people with diabetes, are familiar with these guidelines. As a person with diabetes who injects insulin (or will be injecting insulin in the future), you need to rely on your physician or diabetes educator to use the proper technique for everything diabetes-related: blood glucose monitoring, injecting insulin, counting carbs, etc. But the reality is that this doesn’t always happen, and that means that YOU need to be updated and familiar with the latest and greatest. This week, I’ll share some of the key recommendations to come out of this TITAN workshop. Hopefully none of these are too surprising. If they are, talk to your doctor or educator. You can actually help them get up to speed by mentioning these guidelines. So, here’s what to know: Shorter pen needles are fine. Pen needles come in standard lengths (8 millimeter, or mm, and 12.7 mm). But there’s no real reason to use these length needles specifically. Any adult, regardless of body size can use a shorter needle, meaning a 4-, 5-, or 6-mm needle. If you’re worried that you carry extra weight and that the needle won’t be long enough, don’t. Skin thickness is pretty much the same among all adults, regardless of body fat, body weight, or gender. Remember that the needle injects through the skin layer, and shouldn’t be injecting into muscle. And studies back this up. There’s no evidence that shorter needle use among heavier folks causes insulin leakage, scar tissue Continue reading >>

Gestational Diabetes And Injecting Insulin

Gestational Diabetes And Injecting Insulin

The insulin is often contained in a pen device with a very small needle that works with a spring. The injections are not usually painful, though they may feel worse if you are anxious. Once people learn to relax, they often find that it is straightforward. Insulin is usually injected into fattier areas such as your tummy, buttocks or thighs. It is important to pick different areas to inject in rotation so that lumps don’t develop under the skin. These can stop the insulin being properly absorbed. Some women feel worried about injecting into their tummy during pregnancy and prefer to use their thighs. In late pregnancy you might find it hard to reach your buttocks so your choice might be limited by where you can reach. Steps to injecting insulin Watch this film from Diabetes UK or follow the steps below Your diabetes team will teach you how to inject insulin, but you can use these steps as a quick reminder. You will need: a pen or syringe, a clean needle, a vial of insulin, a swab to clean the skin, a sharps bin for the used needle. Step 1 Expel two units of insulin into the air to make sure the needle is completely full of insulin. Step 2 Make sure you have the correct dose. Step 3 Decide where you are going to inject. Step 4 If you find the injections painful, rub ice on the area for 20 seconds. Then dry it. Step 5 Gently pinch a fold of skin, if your team has taught you to do this (usually only if you are very slim). Step 6 Put the needle in quickly. Step 7 Inject the insulin, making sure you have pushed down the plunger or button fully. Step 8 Count to ten before pulling the needle out. Step 9 If you pinched a skin fold in Step 4, now let it go. Step 10 Dispose of the needle safely in a sharps bin. Step 11 If you have any problems at all, contact your diabetes team Continue reading >>

Ease The Pain Of Insulin Injections

Ease The Pain Of Insulin Injections

Got first-shot fears? Ease apprehension (yours and your child's) and reduce the pain with these tried-and-true tips. Got first-shot fears? Ease apprehension (yours and your child's) and reduce the pain with these tried-and-true tips. Got first-shot fears? Ease apprehension (yours and your child's) and reduce the pain with these tried-and-true tips. Got first-shot fears? Ease apprehension (yours and your child's) and reduce the pain with these tried-and-true tips. Continue reading >>

A Comparison Of Insulin Injection Needles On Patients' Perceptions Of Pain, Handling, And Acceptability: A Randomized, Open-label, Crossover Study In Subjects With Diabetes

A Comparison Of Insulin Injection Needles On Patients' Perceptions Of Pain, Handling, And Acceptability: A Randomized, Open-label, Crossover Study In Subjects With Diabetes

The aim of this study was to assess pain associated with subcutaneous injection into the abdomen and thigh of different combinations of injection speeds and volumes.The study was a single-centre, one-visit, double-blinded, randomised controlled trial in 82 adults with type 1 or type 2 diabetes receiving daily injections of insulin or glucagon-like-peptide-1 (GLP-1) agonists. Participants received 17 subcutaneous injections (12 in abdomen, 5 in thigh) of saline at different injection speeds (150, 300, 450 l/sec), with different volumes (400, 800, 1200, 1600 l), and two needle insertions without any injection. Pain was evaluated on a 100 mm visual analogue scale (VAS) (0 mm no pain, 100 mm worst pain) and on a yes/no scale for pain acceptability.Injection speed had no impact on injection pain (p = 0.833). Injection of larger volumes caused significantly more pain (VAS least-square mean differences 1600 versus 400 l, 7 2 mm [95% confidence interval; 4.6-9.7; p < 0.0001]; 1600 versus 800 l, 7.2 mm [4.4-10.0; p < 0.0001]); 1200 versus 400 l, 3.5 mm [0.4-6.6; p = 0.025]; and 1200 versus 800 l, 3.6 mm [0.4-6.7; p = 0.027]). Significantly more pain occurred in the thigh versus the abdomen (9.0 mm [6.7-11.3; p < 0.0001]).Injection speed had no effect on injection pain, whereas higher injection volumes caused more pain. The results of this study may be of value for guiding patients to use the appropriate injection site and technique to reduce their injection pain. Furthermore, these findings may have important implications for the development of new injection devices and drug formulations for clinical practice. Objective: Insulin injection aspects, such as fear of injection and pain, directly affect glycemic control, patient adherence, and quality of life. Use of thinner and sho Continue reading >>

Injecting Insulin

Injecting Insulin

Injecting insulin at home is done subcutaneously, under the skin, but not into muscle or vein. See also Syringe and Insulin pen. It's best to pull up some loose skin into a tent[1][2], then insert the needle firmly, bevel side up[3][4] for comfort[5]. {C BD has animations with narrations to help you learn how to draw insulin properly[6]. One can select from drawing one insulin or combining two insulins in the same syringe. Selecting this and the style of syringe you use personalizes the demo for your needs. The presentation is very clear and unhurried. BD also has a slideshow which shows how to inject your dog[7] or cat[8]. Injecting any insulin at the same site repeatedly over time or blunting a needle with re-use[10] can cause a lipodystrophy: either lipoatrophy[11] or lipohypertrophy. Either makes absorption unreliable. But varying the injection site can cause variability in action profile, too. This page illustrates[12] illustrates the most common areas humans with diabetes inject insulin and explains how absorption differs in various areas of the human body. This is true for ALL insulins. The new shot area needn't be very far from where the last shot was given--the distance of the width of 2 fingers will do fine as a measure[13]. Most of us dealing with pet diabetes vary the side we give the injections in--right side mornings and left side evenings, for example. This is another help in avoiding giving shots in the same areas[14]. Many people give insulin shots in the scruff of the pet's neck, which is now considered to be a less than optimum choice. The neck area provides poor insulin Absorption, due to it not having many capillaries, veins. etc. (vascularization). Other sites suggested by Dr. Greco include the flank and armpit[15]. Intervet recommends giving injec Continue reading >>

Lump At Insulin Injection Site - Medhelp

Lump At Insulin Injection Site - Medhelp

By subscribing, you agree to the Terms of Use and Privacy Policy Common Questions and Answers about Lump at insulin injection site Hello everyone. Lately every other injection causes a bruising at the site and a lump that goes away by the next morning. Am on shot 18 of neupogen and 26 of Pegasys. Should i just live with this or does anyone have any advice as it gives me the creeps. I have tried changing the angle a bit and not holding the skin so tightly while injecting. Also, how do you give yourself a shot in the upper arm? The achiness eventually subsided after an hour or so, maybe a little longer. I have no idea what that was about. I have no reaction at the site of the injection . So weird.Crisis over but I will call the Shared Solutions nurse tomorrow to let her know about it. Hopefully this was a one time event, whatever it was.I will try the pinching the skin approach. I haven't done this for a while but will give it a go and see if that helps.Thanks again! They occur because insulin stimulates the production of fatty tissue, and are produced by injecting too much insulin in one place. This is where injection site rotation is essential. When skin irritation occurs it is important to completely stop injecting in that area. If pain, swelling, and redness continue, or if you are concerned that there may be an infection, you should call your doctor immediately. if you get a bump after an insulin injection it means that you chose a poor injection site . Insulin absorbs into subcutaneous fat. So wherever you shot and a bump comes up, that means there was not enough fat in that spot to absorb the insulin you just shot.try picking a more fatty area and shooting very slowly. I could just be sitting at work and an episode will happen. It seems so hard to explain what is Continue reading >>

25 September 12 Tips For Reducing Pain With Insulin Injections

25 September 12 Tips For Reducing Pain With Insulin Injections

For those of you with diabetes who take insulin, take heart! While insulin injections can sometimes cause pain or discomfort, there are tips for reducing or eliminating pain. Most of the tips reported here are taken from a presentation given by Stacey Seggelke, MS, RN, CNS, CDE, BC-ADM at the Rocky Mountain Metabolic Syndrome Symposium on May 14, 2010. Alcohol After swabbing your injection site with alcohol, wait for it to DRY before injecting insulin. Alcohol can feel like a burning sensation if it gets pushed in along with the insulin. Temperature Injecting insulin that is cold will hurt more than if it is at room temperature. Remove your unopened insulin from the refrigerator long enough in advance before use so that it is at room temperature when you need to use it. Once your vial or pen is in use, you can store it at room temperature (59F – 86F). Insulin vials can be stored at room temperature for up to 1 month. Most rapid-acting or long acting insulin pens can be stored for up to 28 days at room temperature. However, premixed insulin or intermediate N or NPH pens should be stored for up to only 10 – 14 days. Never guess at your insulin's room temperature storage guidelines - always check the information provided with your insulin for number of days it can be used at room temperature. Unopened insulin can be stored in the refrigerator (36F-46F) up until the expiration date. However, once the expiration date is reached, do not use the insulin – discard it. Dose Higher doses can hurt more than lower doses of insulin. For those of you with Type 2 diabetes, losing weight and regular exercise could improve your insulin sensitivity enough so that less insulin is needed to control your diabetes. And for folks with Type 1 or Type 2 diabetes, good carb counting skills Continue reading >>

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