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Where Do You Inject Insulin?

Using Tresiba® Flextouch®

Using Tresiba® Flextouch®

Do not take Tresiba® if you: are having an episode of low blood sugar are allergic to Tresiba® or any of the ingredients in Tresiba® Before taking Tresiba®, tell your health care provider about all your medical conditions, including if you are: pregnant, planning to become pregnant, or are breastfeeding taking new prescription or over-the-counter medicines, vitamins, or herbal supplements Talk to your health care provider about low blood sugar and how to manage it. Do not take Tresiba® if you: are having an episode of low blood sugar are allergic to Tresiba® or any of the ingredients in Tresiba® Before taking Tresiba®, tell your health care provider about all your medical conditions, including if you are: pregnant, planning to become pregnant, or are breastfeeding taking new prescription or over-the-counter medicines, vitamins, or herbal supplements Talk to your health care provider about low blood sugar and how to manage it. Read the Instructions for Use and take Tresiba® exactly as your health care provider tells you to Do not do any conversion of your dose. The dose counter always shows the selected dose in units Know the type and strength of insulin you take. Do not change the type of insulin you take unless your health care provider tells you to Adults - If you miss or are delayed in taking your dose of Tresiba®: Take your dose as soon as you remember, then continue with your regular dosing schedule Make sure there are at least 8 hours between doses If children miss a dose of Tresiba®: Call the healthcare provider for information and instructions about checking blood sugar levels more often until the next scheduled dose of Tresiba® Check your blood sugar levels. Ask your health care provider what your blood sugar levels should be and when you should che 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: Two Bottle Injection Instructions

Insulin Injection: Two Bottle Injection Instructions

Wash your hands. Pick up the CLOUDY bottle and turn it upside down. Roll the bottle gently between your hands to mix the insulin. Wipe the top of both (clear and cloudy) bottles with alcohol. Remove the caps from the top and bottom of the syringe. Pull the plunger down to the correct unit mark for your CLOUDY insulin dose as ordered. Insert the needle into the CLOUDY bottle. Push the plunger down to inject air into the CLOUDY bottle. Withdraw the empty syringe from the bottle. Set the bottle aside. Pull the plunger down to the correct unit mark for the CLEAR insulin dose as ordered. Insert the needle into the CLEAR bottle. Push the plunger down to inject air into the CLEAR bottle. Leave the needle in the bottle. Turn the bottle upside down with the needle in it. Pull the plunger down to the correct unit mark for the CLEAR insulin dose. Look for air bubbles in the syringe. If you see air bubbles in the syringe, push the insulin back into the bottle, and repeat steps 17 and 18. Pull the bottle away from the needle, and set aside the CLEAR bottle. Pick up the CLOUDY bottle of insulin. Turn the CLOUDY bottle upside down and push the needle into the bottle. Be very careful not to move the plunger. Pull the plunger down and withdraw the correct number of units for the CLOUDY insulin. The plunger should now be on the unit mark showing the total units of both the CLEAR and CLOUDY types of insulin. For example, 6 units of CLEAR insulin are already in the syringe. Add 14 units of CLOUDY insulin for a total of 20 units in the syringe. Pull the bottle away from the needle. Set both bottles on the table. Look for air bubbles in the syringe. If you see air bubbles, discard the dose and begin again. Set the syringe down. Do not let the needle touch anything. Pinch or spread the skin a Continue reading >>

Insulin Injection Areas

Insulin Injection Areas

Look at the dark pink areas on these pictures to find areas of the body where insulin is injected. Inject insulin into: The abdomen, but at least 2 in. (5.1 cm) inches from the belly button. The abdomen is the best place to inject insulin, because your abdomen area can absorb insulin most consistently. The top outer area of the thighs. Insulin usually is absorbed more slowly from this site, unless you exercise soon after injecting insulin into your legs. The upper outer area of the arms. The buttocks. Rotate the location of the injection, and slightly change the injection spot each time you inject insulin. Using the same spot every time can form bumps or pits in the skin. For example, inject your insulin above your belly button, then the next time use your upper thigh, then the next time below your belly button. Continue reading >>

How To Give A Shot Of Insulin For Dogs In 3 Steps

How To Give A Shot Of Insulin For Dogs In 3 Steps

When you have a diabetic dog, changing their diet and lifestyle can seem like the "easy" part compared to having to give your dog a daily insulin shot. Here are 3 easy steps to administering an insulin shot. Take heart, it's actually easier than it looks. If your dog has been diagnosed with canine diabetes, your vet has probably prescribed insulin injections. Insulin is a hormone that helps regulate the body’s blood sugar, or glucose, levels. Dogs with diabetes can only regulate their blood sugar with insulin injections, so you’ll have to learn to give a shot of insulin to your dog. Diabetes affects as many as 1 in 500 dogs. It’s a common health problem, and one that is manageable with consistent treatment and lifestyle changes. Many pet parents are understandably nervous about giving their dog shots, but when properly given they cause only minimal discomfort. Once you master these steps, the process will be a quick part of your—and your dog’s—routine. Your veterinarian will give you the proper dosage and the number of shots a day your dog needs –it’s important to give the injections at the same time each day. Step 1. Store the insulin carefully Insulin can be a fragile substance. It should not be exposed to direct sunlight or stored in high temperatures. Keep your unused bottles in the refrigerator, not frozen. Storing it in the fridge door is often recommended. If the insulin bottle looks frosted, was possibly exposed to heat, or the liquid seems unevenly colored, start with a new vial to be safe. Do not use insulin past the expiration date on the bottle. TIP: Although insulin is sensitive to extreme temperatures, bringing it to room temperature before use will not harm the hormone and may be more comfortable at the injection site for your pet. Step 2. Continue reading >>

Suitable Injection Sites

Suitable Injection Sites

Insulin is not absorbed at the same speed at all sites Abdomen and thighs are the most common injection sites.2 At least 1 cm distance from the navel for adults. At least 3 cm distance from the navel for children. Injection sites on the abdomen allow rapid insulin absorption. Injection sites on the thighs and buttocks allow slower insulin absorption for some insulins. The effect of analog insulins is less dependent on the injection site. Follow the recommendations given by your healthcare professional. Rotation principle for injection sites – Avoiding lipohypertrophy Change the injection site after every injection (rotation principle). For adults, the injection sites should be at least 1 cm away from each other to avoid frequent injections into so-called “favourite sites” and thus leading to tissue hardening (lipohypertrophy). Example 1 Example 2 Example 3 2 Upper arms as injection sites: injections into the upper arms should only be performed after training by your healthcare professional. The reason is a higher risk of injecting into the muscle as the subcutaneous fatty tissue is usually thin and injection sites are not easily accessible. Continue reading >>

Insulin Administration

Insulin Administration

Insulin is necessary for normal carbohydrate, protein, and fat metabolism. People with type 1 diabetes mellitus do not produce enough of this hormone to sustain life and therefore depend on exogenous insulin for survival. In contrast, individuals with type 2 diabetes are not dependent on exogenous insulin for survival. However, over time, many of these individuals will show decreased insulin production, therefore requiring supplemental insulin for adequate blood glucose control, especially during times of stress or illness. An insulin regimen is often required in the treatment of gestational diabetes and diabetes associated with certain conditions or syndromes (e.g., pancreatic diseases, drug- or chemical-induced diabetes, endocrinopathies, insulin-receptor disorders, certain genetic syndromes). In all instances of insulin use, the insulin dosage must be individualized and balanced with medical nutrition therapy and exercise. This position statement addresses issues regarding the use of conventional insulin administration (i.e., via syringe or pen with needle and cartridge) in the self-care of the individual with diabetes. It does not address the use of insulin pumps. (See the American Diabetes Association’s position statement “Continuous Subcutaneous Insulin Infusion” for further discussion on this subject.) INSULIN Insulin is obtained from pork pancreas or is made chemically identical to human insulin by recombinant DNA technology or chemical modification of pork insulin. Insulin analogs have been developed by modifying the amino acid sequence of the insulin molecule. Insulin is available in rapid-, short-, intermediate-, and long-acting types that may be injected separately or mixed in the same syringe. Rapid-acting insulin analogs (insulin lispro and insulin a Continue reading >>

Insulin Injection Sites: Where And How To Inject

Insulin Injection Sites: Where And How To Inject

Insulin is a hormone that helps cells use glucose (sugar) for energy. It works as a “key,” allowing the sugar to go from the blood and into the cell. In type 1 diabetes, the body doesn’t make insulin. In type 2 diabetes, the body doesn’t use insulin correctly, which can lead to the pancreas not being able to produce enough — or any, depending on the progression of the disease —insulin to meet your body’s needs. Diabetes is normally managed with diet and exercise, with medications, including insulin, added as needed. If you have type 1 diabetes, insulin is required for life. This may seem difficult at first, but you can learn to successfully administer insulin with the support of your healthcare team, determination, and a little practice. There are different ways to take insulin, including syringes, insulin pens, insulin pumps, and jet injectors. Your doctor will help you decide which technique is best for you. Syringes remain a common method of insulin delivery. They’re the least expensive option, and most insurance companies cover them. Syringes Syringes vary by the amount of insulin they hold and the size of the needle. They’re made of plastic and should be discarded after one use. Traditionally, needles used in insulin therapy were 12.7 millimeters (mm) in length. Recent research shows that smaller 8 mm, 6 mm, and 4 mm needles are just as effective, regardless of body mass. This means insulin injection is less painful than it was in the past. Insulin is injected subcutaneously, which means into the fat layer under the skin. In this type of injection, a short needle is used to inject insulin into the fatty layer between the skin and the muscle. Insulin should be injected into the fatty tissue just below your skin. If you inject the insulin deeper int Continue reading >>

Choosing An Injection Site

Choosing An Injection Site

Do not take Lantus® during episodes of low blood sugar or if you are allergic to insulin or any of the inactive ingredients in Lantus®. Do not share needles, insulin pens, or syringes with others. Do NOT reuse needles. Before starting Lantus®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breast-feeding or planning to breast-feed. Heart failure can occur if you are taking insulin together with certain medicines called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you already have heart failure, it may get worse while you take TZDs with Lantus®. Your treatment with TZDs and Lantus® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms of heart failure, including: Sudden weight gain Tell your doctor about all the medications you take, including OTC medicines, vitamins, and supplements, including herbal supplements. Lantus® should be taken once a day at the same time every day. Test your blood sugar levels while using insulin, such as Lantus®. Do not make any changes to your dose or type of insulin without talking to your healthcare provider. Any change of insulin should be made cautiously and only under medical supervision. Do NOT dilute or mix Lantus® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Lantus® must only be used if the solution is clear and colorless with no particles visible. Always make sure you have the correct insulin before each injection. While using Lantus®, do not drive or operate heavy machinery until Continue reading >>

8 Ways To Take Insulin

8 Ways To Take Insulin

How to take insulin Need insulin? While the drug itself may be old—nearly 90 years to be exact—there’s lots of new things happening when it comes to ways to take it. From the old-fashioned needle and syringe to injector pens to pumps, you’ve got choices to make. There’s even a plethora of devices that can help you inject if you have poor vision or mobility issues. Check out these eight options and talk with your certified diabetes educator to determine which insulin delivery system or injection aids are right for you. Needle and syringe With this type of delivery system, you insert a needle into a vial, draw up the appropriate amount of insulin, and then inject into the subcutaneous space—the tissue just under your skin. Here are 5 types of insulin and 9 factors that affect how insulin works. Even though there are other options, needles and syringes remain the most common way to take insulin. Some of the new insulin injection methods, such as the insulin pen, carry only a preset amount of insulin. Thinner needles and other advancements, such as syringe magnifiers, have made syringes easier to use. Syringe magnifier Have poor vision? You’re not alone. According to the American Diabetes Association, diabetes is the leading cause of new cases of blindness among adults aged 20–74 years. Needle guides can help you keep the syringe or pen steady at the desired location and at the correct angle both for drawing up insulin out of the vial and injecting. Some needle guides also come with magnifiers, which help by enlarging the numbers and allowing you to read the fine print and dosages on the syringe. Syringe-filling device These devices are another example of innovations designed to help make insulin needles more palatable. Syringe-filling devices allow a person Continue reading >>

Choosing Best Body Site For An Insulin Shot

Choosing Best Body Site For An Insulin Shot

In the past, doctors and nurses told patients to rotate their insulin shots to different sites on their bodies. Now we know that it's best to take insulin shots in the part of the body that matches the insulin action a person wants. See Illustration: Sites for Injecting Insulin Injection Areas and Action Insulin enters the bloodstream faster from some areas of the body than from others. Where you take your shot can affect your blood sugar levels. Generally, insulin enters the blood: Fastest from the abdomen (stomach area). A little slower from the arms. Even more slowly from the legs. Slowest from the buttocks. Exercising can also speed up the amount of time it takes for the insulin to enter your blood. You can figure out where to take your shot based on how quickly or slowly you want the insulin to enter your bloodstream. For example, if you're going to be exercising, such as walking or doing any kind of lifting, you probably don't want to take your shot in your leg or arm. Exercising those areas quickens the amount of time it takes for the insulin to get into your blood stream. This can cause your blood sugar to drop suddenly during or right after you exercise. If you plan to eat right after taking your shot, you might use a site on your stomach. That way the insulin will be available faster to handle the rise in your blood sugar after the meal. Rotate Sites in the Same Area Follow these guidelines when you choose a site to take your shot. Try to be consistent in where you take your shots. Always take your shot of fast-acting insulin in the stomach or arm. Take slower-acting insulin in the leg or buttocks. Try to avoid using the exact spot you used for your last shot. For example, space your next shot just an inch or so from your last previous shot. If you use the sam Continue reading >>

How To Give A Painless Injection

How To Give A Painless Injection

If you have Type 2 diabetes, sooner or later you may require insulin injections, either temporarily (as during infections) or permanently. This is nothing to be afraid of, even though many people with long-standing Type 2 diabetes literally spend years worrying about it. I usually teach all my patients how to inject themselves at our first or second meeting, before there’s any urgency. Once they give themselves a sample injection of sterile saline (salt water), they find out how easy and painless it can be, and they are spared years of anxiety. If you’re anxious about injections, after you read this section, please ask your physician or diabetes educator to allow you to try a self-administered injection. Insulin is usually injected subcutaneously This means Into a layer of fat under the skin The regions of the body that usually contain appropriate deposits of fat are illustrated in Figure 1 Examine your body to see if you have enough fat at the illustrated sites to comfortably grab a big hunk between your thumb and first finger. Fig 1 Potential sites for subcutaneous injections. To show you how painless a shot can be, your teacher should give himself or herself a shot and leave the syringe dangling in place, illustrating that no pain is felt Your teacher should next give you a shot of saline to prove the point. Now it’s time for you to give yourself an injection, using a syringe that’s been partly filled for you with about 5 “units” of saline. 1. With your “nonshooting” hand, grab as big a chunk of skin plus underlying fat as you can hold comfortably. If you have a nice roll of fat around your waist, use this site. If not, select another site from those illustrated in Figure 1 Nearly everyone has enough subcutaneous buttocks fat to inject there without g Continue reading >>

Diabetes, Insulin Administration Tips

Diabetes, Insulin Administration Tips

If your pet has diabetes, your veterinarian may have prescribed insulin for her. Some pet owners balk at the idea of giving their pet a regular injection, but the types of syringes used, the small amount injected, and the ease of injecting subcutaneously ensure that most pet owners can quickly learn to give the most comfortable injection possible. Insulin measurement: The concentration of insulin is measured in units. Insulin syringes are marked in units, and may also be marked in milliliters. Be sure to use the unit scale. Also, be sure you are using the appropriate insulin syringe for the concentration of insulin you are using. Insulin is available in concentrations of 40 and 100 units/ml. There are corresponding syringes to use for the measurement of the two concentrations of insulin. Pharmacy Note: Insulin comes in a glass vial with a rubber stopper, and must be stored in the refrigerator. Do not use the insulin beyond its expiration date. Different insulin types require different syringes: It is imperative to measure and administer the correct dose of insulin using the correct syringe. For instance, if you use insulin with 40 U/ml, you must measure and administer it with a U-40 syringe; if you used a U-100 syringe, it would result in the wrong amount of insulin being given, with perhaps a fatal outcome. Find out from your veterinarian (or pharmacist) what syringes are available for you to use with the concentration of insulin your pet is receiving. Pharmacy Note: An insulin syringe has 4 basic parts: the barrel, plunger, needle, and needle guard. Many brands of syringes have the needle permanently attached to the syringe barrel so it cannot be removed. How to draw up insulin for your pet: Prior to removing a dose of insulin from the vial, mix the contents by gently Continue reading >>

Insulin: The Holy Grail Of Diabetes Treatment

Insulin: The Holy Grail Of Diabetes Treatment

Insulin is a hormone made by beta cells in the pancreas. When we eat, insulin is released into the blood stream where it helps to move glucose from the food we have eaten into cells to be used as energy. In people with type 1 diabetes, the body produces little or no insulin as the cells that produce insulin have been destroyed by an autoimmune reaction in the body. Insulin replacement by daily injections is required. In people with type 2 diabetes the body produces insulin but the insulin does not work as well as it should. This is often referred to as insulin resistance. To compensate the body makes more but eventually cannot make enough to keep the balance right. Lifestyle changes can delay the need for tablets and/or insulin to stabilise blood glucose levels. When insulin is required, it is important to understand that this is just the natural progression of the condition. RMIT University have produced a short overview of insulin, a drug that keeps in excess of one million Australians alive. Watch the video to understand why insulin is important and why so many Australians rely on it to stay alive. Copyright © 2015 RMIT University, Prepared by the School of Applied Sciences (Discipline of Chemistry). At this stage, insulin can only be injected. Insulin cannot be given in tablet form as it would be destroyed in the stomach, meaning it would not be available to convert glucose into energy. Insulin is injected through the skin into the fatty tissue known as the subcutaneous layer. You do not inject it into muscle or directly into the blood. Absorption of insulin varies depending on the part of the body into which you inject. The tummy (abdomen) absorbs insulin the fastest and is the site used by most people. The buttocks and thighs are also used by some people. While i Continue reading >>

Where Is The Best Place To Give Yourself Insulin Shots?

Where Is The Best Place To Give Yourself Insulin Shots?

A: Insulin must be given into subcutaneous fatty tissue in order to absorb correctly. The preferred sites are the fatty tissue in the back of the upper arm, the abdomen (avoiding the belly button), the area on the top, middle outer aspect of the thigh, and the top of the buttock. Of these sites none is better than the others; it really depends on what is most convenient for you and the plan you have for rotating the injection sites. For instance, if you use the thigh for your morning Humalog before breakfast, then you may want to use the back of the arm for your lunchtime dose and your abdomen for your evening dose. Some people adjust their injection sites based upon how high their blood glucose level is, using the abdomen for quickest absorption and the buttock for slowest. However, with the newer insulins, injection site choice has less effect on absorption than was the case with NPH and regular insulin. Levemir is not approved for use in the buttock area, so this site should be avoided for your Levemir dose. Concerning how far apart to give Humalog and Levemir, we recommend injecting Humalog and Levemir at least 3 inches apart. Continue reading >>

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