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Why Insulin Injected Subcutaneously

How To Give A Subcutaneous Injection

How To Give A Subcutaneous Injection

Before the Injection Some medications such as Kineret® and Enbrel® must be injected. These medications come with a kit and a device to inject the medication. Some patients however prefer not to use the kit but to do the injection themselves; much like an insulin injection would be done. If your medication is refrigerated, remove the vials from the refrigerator 30 minutes before administration so it can reach room temperature. Select a clean, dry work area. Gather your supplies: – Medication – Sterile water – Sterile disposable needles and syringes – Alcohol pads or cotton balls and bottle of rubbing alcohol – Puncture-proof disposal container* – Bandaids Wash your hands well before preparing your medication. *HINT The container can be a coffee can or leak-proof, closable milk jug. Find out the proper way to dispose of biological waste in your area. Preparing the Injection Your doctor and/or clinic nurse will instruct you on preparing your particular dose of medication. Giving Yourself the Injection Select your injection site. This must be an area that has a layer of fat between the skin and the muscle. This is called subcutaneous. The following parts of your body have subcutaneous layers: outer surface of the upper arm top of thighs buttocks abdomen, except the navel or waistline If you are very thin do not use the abdomen as an injection site. Do not use the same site for injections each time. Rotate your injection sites in a regular pattern. You should be at least 1 ½ inches away from the last injection site. Jot down on your calendar where you gave you last shot. This will help prevent giving the shot in the same place too soon. Select a site and cleanse the area (about 2 inches) with a fresh alcohol pad, or cotton ball soaked in alcohol. Wait for the Continue reading >>

Test Of The Efficacy And Safety Of Insulin Glulisine Injected Subcutaneously In Patients With Type 1 Diabetes Mellitus (portal 1)

Test Of The Efficacy And Safety Of Insulin Glulisine Injected Subcutaneously In Patients With Type 1 Diabetes Mellitus (portal 1)

Primary Objective: To evaluate the efficacy and the safety of insulin glulisine in type I Diabetes Melittus (DM) patients Secondary Objective: To evaluate the insulin glulisine doses To assess the patient satisfaction Study Type : Interventional (Clinical Trial) Actual Enrollment : 68 participants Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Multicentre, Open, Non-randomised Controlled Phase IV Clinical Trial of Efficacy and Safety for Insulin Glulisine Injected Subcutaneously in Patients With Type 1 Diabetes Mellitus Using Also Insulin Glargine Study Start Date : July 2009 Primary Completion Date : July 2010 Study Completion Date : July 2010 Resource links provided by the National Library of Medicine U.S. FDA Resources Arm Intervention/treatment Experimental: APIDRA + LANTUS basal The 2 first weeks, patients will receive subcutaneous injection of Insulin Glulisine and Insulin Glargine once daily in hospital. The rest of the treatement is to be take at home until week 12 Drug: INSULIN GLULISINE (HMR1964) Pharmaceutical form: APIDRA 100U/ml flacon for the titration period in the hospital APIDRA 100U/ml solution for injection in cartridge in OptiSet Route of administration: 3-4 subcutaneous injections per day Drug: INSULIN GLARGINE Pharmaceutical form: LANTUS 100U/ml solution for injection in cartridge Route of administration: Once daily subcutaneous injection in the evening Secondary Outcome Measures : Mean Glycosylated haemoglobin (HbA1c) [ Time Frame: Week 12 ] Mean Fasting Blood Glucose and mean Post Prandial Glycemia [ Time Frame: Week 12 ] Number of documented symptomatic hypoglycaemic episodes [ Time Frame: From week 0 to week 12 ] Mean dose and mean dose change of insul Continue reading >>

Model Study Of The Pressure Build-up During Subcutaneous Injection

Model Study Of The Pressure Build-up During Subcutaneous Injection

Citation: Thomsen M, Hernandez-Garcia A, Mathiesen J, Poulsen M, Sørensen DN, Tarnow L, et al. (2014) Model Study of the Pressure Build-Up during Subcutaneous Injection. PLoS ONE 9(8): e104054. Editor: Juan Carlos del Alamo, University of California San Diego, United States of America Received: March 21, 2014; Accepted: July 4, 2014; Published: August 14, 2014 Copyright: © 2014 Thomsen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its Supporting Information files. Funding: The authors have no support or funding to report. Competing interests: The authors Maria Thomsen, Mette Poulsen, and Dan N. Sørensen are employees of Novo Nordisk A/S. The authors confirm that the company has no competing interests or financial disclosures and declare that the affiliation to Novo Nordisk A/S does not alter the authors' adherence to PLOS ONE policies on sharing data and materials. Continue reading >>

Why Is Insulin Injected Instead Of Taken By Mouth?

Why Is Insulin Injected Instead Of Taken By Mouth?

Insulin cannot be taken orally because it would break down in the digestive process. Insulin is a poly-peptide protein, which can be broken down by enzymes in the digestive system. By the time it reaches the small intestine, where it is absorbed, it is only a single peptide and can no longer function as insulin. Besides the chemical reasons for not ingesting insulin, there are other reasons that have more to do with the management of diabetes. Why Injection Is Better Blood sugar levels are subject to great change throughout the day. What foods were consumed, exercise, stress, illness, even time of day – all of these impact glucose levels. If this were not so, there would be no need to monitor levels with a finger prick multiple times each day. Insulin is needed to ensure that glucose is properly utilized and that levels of glucose remain stable. In order to work properly, insulin must enter the bloodstream intact. By injecting it into the subcutaneous tissue in our bodies, it is designed to be absorbed into the bloodstream without changing its properties and within a proscribed amount of time. Insulin should not be injected directly into muscle or into the bloodstream, as both will increase the speed of absorption. How fast absorption happens is also a function of what type of insulin is being used: rapid-acting, short-acting, intermediate-acting, long-acting or a mix of some of these. Each is designed to be absorbed and active over certain time frames, in order to cope with different glucose control needs, like consuming a meal or sleeping all night. Possible New Alternatives There is active research to develop alternatives to injections. One of the most promising is inhaled insulin. There was an inhaled insulin product, Exubera, on the market for about a year betwee 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 >>

Comparison Between Intradermal And Subcutaneous Insulin Delivery Via A Novel Biphasic Model Of Insulin Absorption

Comparison Between Intradermal And Subcutaneous Insulin Delivery Via A Novel Biphasic Model Of Insulin Absorption

Comparison between Intradermal and Subcutaneous Insulin Delivery Via a Novel Biphasic Model of Insulin Absorption Intradermal insulin delivery Intradermal insulin delivery is an attractive alternative to subcutaneous insulin delivery due to more rapid absorption kinetics that could potentially improve glycemic control in patients with diabetes.[br]Using a recently developed model of insulin kinetics, we differentiated two phases of insulin absorption and compared their dynamics for intradermal vs. subcutaneous injection.[bold] [/bold]Nine healthy male subjects received injections of 10 U of Lispro on two occasions, using intradermal and subcutaneous route of delivery, respectively. Plasma insulin was measured frequently following a variable schedule (more frequent for the first hours) over 6 hours.[br]Insulin absorption was assessed using a biphasic rate model, which has been shown to fit intradermal data better than a standard one-phase compartmental approach. Model parameters were fitted per subject using weighted mean square error minimization. Repeated- measures ANOVA was used for the statistical comparisons.[br]The study results are summarized in the figure showing the average (across subjects) cumulative insulin absorption patterns for intradermal and subcutaneous delivery. Both the first and the second phases of insulin appearance were significantly faster with intradermal insulin delivery (30 vs. 60 min. to first peak, p=0.005, and 68 vs. 102 min. to second peak, p=0.018). The intradermal route was, as expected, also significantly faster overall (p[lt]0.001).[br]In conclusion, a novel model of insulin kinetics showed that: (i) two phases of insulin absorbtion can be differentiated for both intradermal and subcutaneous delivery, and (ii) these phases are more pro Continue reading >>

Subcutaneous Injection

Subcutaneous Injection

"Subcut" redirects here. For the song by Grand Mixer DXT featuring Bill Laswell, see Aftermathematics. Play media 3D animation of a subcutaneous injection A subcutaneous injection is administered as a bolus into the subcutis,[1] the layer of skin directly below the dermis and epidermis, collectively referred to as the cutis. Subcutaneous injections are highly effective in administering vaccines and medications such as insulin, morphine, diacetylmorphine and goserelin. Subcutaneous, as opposed to intravenous, injection of recreational drugs is referred to as "skin popping". Subcutaneous administration may be abbreviated as SC, SQ, sub-cu, sub-Q, SubQ, or subcut. Subcut is the preferred abbreviation for patient safety.[2] Subcutaneous tissue has few blood vessels and so drugs injected here are for slow, sustained rates of absorption.[3] It is slower than intramuscular injections but still faster than intradermal injections.[3] Injection sites[edit] Subcutaneous injection sites Sites include,[3] The outer area of the upper arm. The abdomen, from the rib margin to the iliac crest and avoiding a 2-inch circle around the navel. This has the fastest rate of absorption among the sites. The front of the thigh, midway to the outer side, 4 inches below the top of the thigh to 4 inches above the knee. This has a slower rate of absorption than the upper arm. The upper back. The upper area of the buttock, just behind the hip bone. This has the slowest rate of absorption among the sites. Equipment[edit] A 25 to 31 gauge thick, 3/8" to 1" long needle can be used. The size is determined by the amount of subcutaneous tissue present, which is based on patient build. The 3/8" and 5/8" needles are most commonly used. Usually, no more than 1 mL of solution is given, compared to intradermal i Continue reading >>

Practical Use Of Regular Human Insulin

Practical Use Of Regular Human Insulin

Regular human insulin Human regular insulin was introduced in 1982, as the first product of bio-engineering. Despite the fact that the practical differences between the (then already highly purified) animal insulins and human insulin were limited, it did not take long for the animal insulin preparations to be replaced by their human counterparts. This was partly the result of strong marketing from those who produced the human insulin and partly the result of the intuitive notion that because it was human, it was bound to be better. Regular human insulin can be injected subcutaneously, intramuscularly, and intravenously. As in physiological situation in the pancreas, in the clinical preparation a little Zinc is present. Insulin has a tendency to self-associate to hexamers (six insulin molecules bound together) around a Zinc atom, which improves water solubility. However, this results in a slight delay in the absorption of regular insulin when injected subcutaneously; it does not materially affect intravenous injection. Subcutaneous use After s.c. injection insulin levels peak after about 90 minutes and then slowly dissipates in 4 to 6 hours; metabolic action peaks after 2 to 3 hours. Because of this relatively slow onset of action, it is recommended to inject regular insulin 30-45 minutes before the meal to have the insulin peak coincide better with the meal-related rise in glucose. However, the evidence for this recommendation is poor, and for reasons of practicality many patients tend to ignore this advice. When using higher dosages (above approx. 50 IU) the rapidity of action tends to diminish, so it is recommended to split the dose in two separate injections (see also Pharmacokinetics and -dynamics of insulin absorption). Intravenous use After i.v. injection regular 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 >>

Giving A Subcutaneous (sub-q) Injection (single Medicine)

Giving A Subcutaneous (sub-q) Injection (single Medicine)

Giving yourself a subcutaneous injection (also called a sub-Q injection) means inserting medicine into the fatty areas just under your skin. The needle used for a sub-Q injection is very small and doesn’t cause much pain. Many medicines are given in this way. Your healthcare provider has prescribed the amount and times you need to give the medicine. The name of my medicine is: ______________________ Amount per injection: ____________________________ Times per day: _________________________________ Step 1. Preparing a work area Put any pets in another room. Wash your hands for 1 to 2 minutes with liquid soap. Clean your area with soap and water. Dry with a paper towel. Step 2. Gathering your supplies Collect the following items: Your medicine. Keep in mind that some medicine vials must be taken out of the refrigerator at a specific amount of time before you inject them. Read the label and follow the instructions. A sterile disposable syringe (don’t reuse your syringes) Alcohol wipes or swabs Special container to throw out the used syringe (sharps container). You can buy a sharps container at a pharmacy or medical supply store. You can also use an empty laundry detergent bottle, or any other puncture-proof container and lid. Then wash your hands again. Step 3. Choosing your injection site You may find that the easiest and safest places to inject medicine are these areas: Back of your upper arms Upper thighs Belly (abdomen), but avoid the belly button and waist area If you are very thin, don’t use your belly for your injection site, unless your healthcare provider tells you to. Avoid areas that are red, swollen, or bruised. Don't inject in the same site twice in a row. Choose a site that is at least 2 inches away from your last injection site. Step 4. Getting the med Continue reading >>

Subcutaneous Injection At Home

Subcutaneous Injection At Home

Your health professional has prescribed special medicine for your child, which must be given by injection. Supplies you will need: Prescribed medication Alcohol pad Syringe and needle Container for disposal Drawing up the medication Wet your hands first and then wash your hands with soap and water. Count to 20 while washing. Rinse and dry with clean paper or cloth towel. Check the medication bottle before using it. Look at the label and check that you have the correct medication and concentration. Make sure that the expiration date has not passed and that the top of the bottle is not damaged. Make sure the medication has not changed color or consistency. Follow the bottle instructions for mixing the medication prior to use. Clean the top of the bottle with an alcohol pad. Allow it to dry. Do not touch the top of the bottle after cleaning it. Remove the needle cover from the syringe by pulling it straight off. Lay the cover on a flat surface. Draw air into the syringe by pulling back on the plunger to the amount of medication to be given. Insert the needle into the rubber stopper of the bottle and push air into the bottle by pushing the plunger. Leaving the syringe in the bottle, slowly pull the plunger down past the dose of medication you need to give. If there are no air bubbles, push the plunger up to the line to the exact dose of medication you need to give. The top of the rubber plunger should be on the desired amount (not bottom of plunger). If there are air bubbles in your syringe, flick or tap the syringe with your finger. When the air bubble goes to the top of the syringe, push the plunger tip up to push the air out of the syringe into the medication vial. Make sure the needle tip is in the medication fluid, and then pull the plunger back to the exact dose for i Continue reading >>

Structural Biochemistry/subcutaneous

Structural Biochemistry/subcutaneous

A subcutaneous injection (SC, SQ, SubQ) is a method of drug administration in which the drug is injected into hypodermis, the fatty tissue layer directly beneath the dermis and epidermis. Because there is limited blood flow to the hypodermis, subcutaneous injection is usually used when slow absorption of medication is preferred.[1] Drugs that are administered using this method must be soluble and potent in small concentrations. Common medications used with this procedure include heparin, insulin, growth hormones, and vaccines against MMR and varicella. With subcutaneous injection, the drug is usually administered through loose interstitial tissues of the upper arm, the anterior surface of the thigh, the lower portion of the abdomen, or the lower back. When injecting, the skin is pinched up to prevent injection into muscle. It is recommended to use the same site for routine injections. The shot is given at a straight 90 degree angle if at least 2 inches of skin can be grasped. Otherwise, it is given at a 45 degree angle.[2] Factors that may increase absorption rate are heat, massaging, co-administers vasodilators, or hyaluronidase at the site of injection. Epinephrine may decrease the absorption rate due to decreased blood flow. Continue reading >>

Is There A Better Way To Give An Insulin Injection?

Is There A Better Way To Give An Insulin Injection?

M.S., R.D., L.D.N., C.D.E. Manager of Nutritional Education at Joslin Diabetes Center Is there a proper way to give an insulin injection? Yes, according to a report that came out of the Third Injection Technique workshop in Athens (TITAN) in September 2009. Prior to this report there was very little consensus on the proper way to inject insulin and even less research available to back it up. Health practitioners like to use evidenced-based guidelines as the foundation for the recommendations we give to patients. That means that we have the results of controlled research studies at our disposal. But medicine is both an art and a science, and although we would like to have research to back up our decisions sometimes ,we often rely on consensus statements or fall back on prior personal experience. Until recently there was little standardization across the country on how to best teach patients to give an injection. In September of last year, the Journal Diabetes & Metabolism published a special issue devoted to the results from the TITAN workshop on injection recommendations for patients with diabetes. One hundred and twenty-seven injection experts from around the world reviewed 157 articles and the survey results of 4300 insulin-injecting patients with diabetes and came up with a set of new recommendations. These recommendations have not been accepted universally, but we at Joslin Diabetes Center are in the processing of looking at our own procedures in light of them. Why We Need Standards – Results of the Injection Survey Some findings: 21% of patients admitted injecting into the same site for a whole day or even for a few days. 50% of patients had symptoms suggestive of lipohypertrophy (a lump under the skin caused by accumulation of extra fat at the site of many subcu Continue reading >>

Basaglar Insulin Glargine Subcutaneous Injection

Basaglar Insulin Glargine Subcutaneous Injection

BASAGLAR (insulin glargine) Injection DESCRIPTION BASAGLAR (insulin glargine injection) is a long-acting insulin for subcutaneous use. Insulin glargine is a recombinant human insulin analog [see CLINICAL PHARMACOLOGY]. BASAGLAR is produced by recombinant DNA technology utilizing a non-pathogenic laboratory strain of Escherichia coli (K12) as the production organism. Insulin glargine differs from human insulin in that the amino acid asparagine at position A21 is replaced by glycine and two arginines are added to the C-terminus of the B-chain. Chemically, insulin glargine is 21A-Gly-30B-a-L-Arg-30Bb-L-Arg-human insulin and has the empirical formula C267H404N72O78S6 and a molecular weight of 6063. Insulin glargine has the following structural formula: BASAGLAR is a clear, colorless, sterile aqueous solution of insulin glargine. Each milliliter of BASAGLAR (insulin glargine injection) contains 100 units (3.6378 mg) insulin glargine. The 3 mL BASAGLAR KwikPen contains the following inactive ingredients per mL: 30 mcg zinc, 2.7 mg metacresol, 17 mg glycerin, and water for injection. The pH is adjusted by addition of aqueous solutions of hydrochloric acid and sodium hydroxide. BASAGLAR has a pH of approximately 4. BASAGLAR® is indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. BASAGLAR is not recommended for the treatment of diabetic ketoacidosis. DOSAGE AND ADMINISTRATION Train patients on proper use and injection technique before initiating BASAGLAR. Visually inspect BASAGLAR KwikPen for particulate matter and discoloration prior to administration. Only use if the solution is clear and colorless with no visible particles. Inject between 1 and 60 units per injection. Administer BAS Continue reading >>

How To Give A Subcutaneous Injection

How To Give A Subcutaneous Injection

Reader Approved Three Parts:Preparing for a Subcutaneous InjectionDrawing a Dose of MedicationGiving a Subcutaneous InjectionCommunity Q&A A subcutaneous injection is an injection administered into the fatty area just under the skin (as opposed to an intravenous injection, which is administered directly into the bloodstream). Because they give a slower, more gradual release than intravenous injections, subcutaneous injections are frequently used as a way to administer both vaccines and medications (for instance, type I diabetics often use this type of injection to administer insulin.). Prescriptions for medications requiring subcutaneous injections are usually accompanied by detailed instructions on the correct way to give the injection. The instructions in this article are intended to be used only as a guideline - contact a medical professional before you give any injections at home. Read on below the jump for detailed instructions. 1 Gather your supplies. Performing a subcutaneous injection properly requires more than just a needle, syringe, and medicine. Before proceeding, make sure you have the following: A sterile dose of your medication or vaccine (usually in a small, labeled vial) A suitable syringe with a sterile needle tip. Depending on the size of your patient and the amount of medication to be administered, you may choose to use one of the following configurations or another safe, sterile means of injection: A 0.5, 1, or 2 cc syringe with a 27-gauge needle A 3 cc luer lock syringe (for large doses) A pre-filled, disposable syringe A sterile gauze pad (usually 2 x 2 inch) A sterile adhesive bandage (note - make sure the patient is not allergic to the adhesive, as can lead to irritation near the wound) A clean towel 2 Ensure you have the correct medication and Continue reading >>

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