Insulin is a hormone secreted by the pancreas - an organ which apart from producing juices that help in digestion of food , also produces certain hormones which have wide ranging effects on body metabolism.
While it has other effects, insulin's principal effect is uptake of glucose by the cells of the body and is mostly released by the pancreas in response to increased blood glucose.
In conditions like Diabetes Mellitus (DM) there is decreased/absent insulin production ( type 1 ) or decreased sensitivity of cells to glucose (type 2 ) , resulting in elevated blood glucose levels that have deleterious effects on the body.
Insulin therefore is prescribed to people with type 1 DM or sometimes in people with type 2 when medication alone doesn't provide satisfactory results.
Insulin is always administered as an injection.
It cannot be taken orally because it is a peptide hormone - and peptides get digested in the digestive tract.
Being a huge potential market, several efforts are underway to develop an orally administered form of insulin.
Intra nasal insulin is also under study.
Such options would go a long way in improving diabetes management.
Insulin is injected into the subcutaneous layer of the skin.
There are various sites on the body where it can be administered this way.
These will be described subsequently.
Methods include using syringes for each dose or an insulin pump which administers doses throughout the day.
How to administer insulin It is imperative if you're injecting for the first time , that you learn this from your health care provider.
The following steps are only a rough guide and not a substitute.
1.
Get everything needed - insulin vials, syringes, spirit swabs 2.
Check insulin vial.
A newly opened vial should not be used more than a month as the insulin would have undergone degradation by then.
3.
Wash hands with soap and water.
4.
Mix the insulin in the vial gently.
5.
Use a spirit swab to clean to top of the insulin vial.
Let it dry.
6.
Remove the protective sheath of the insulin syringe - withdraw plunger till the required dose is set.
Do not touch the needle at any point during the whole process.
7.
Insert the needle of the syringe into the rubber cap of the insulin vial.
Inject the air inside the syringe into the vial by pressing on the plunger.
8.
Turn the vial upside down and withdraw plunger slowly till the amount of insulin in the syringe is slightly more than the required dose.
9.
Remove the syringe from the vial.
10.
Hold syringe with needle facing upwards.
Tap gently so that air bubbles if any will rise up.
Push the plunger slowly till all the air bubbles are expelled and a little insulin comes out through the needle.
11.
Identify the site where you want to inject and clean with a spirit swab - wait till the skin dries.
12.
Hold the skin between forefinger and thumb gently raising a fold of skin.
13.
With the other hand , take the syringe and enter the fold of skin with the needle at 90 degrees to the surface.
With experience you will get to know how deep to enter.
14.
Depress the plunger fully so that all the insulin is injected.
15.
Withdraw the syringe at the same angle.
16.
If there is slight bleeding, apply pressure with the spirit swab.
Do not rub the area.
17.
Dispose of the needle carefully.
You could have a plastic container where you can dispose the syringes.
Do not attempt to resheath the needle after using.
These could be regularly disposed of at the hospital or lab.
18.
Do not reuse used syringes.
Apart from sterile concerns, a used needle undergoes blunting and wearing away of its protective covering - therefore entering the skin with it causes more trauma and damage to the tissue.
19.
Keep the insulin vial back in the refrigerator.
20.
Keep the other supplies in their designated areas.
Insulin is injected into the subcutaneous tissue just under the skin.
Areas on the body where people can inject insulin most easily are: 1.
the abdomen, except the area around the navel 2.
he upper and outer areas of the arms 3.
the front and the outside of the thighs 4.
the area just above the waist on the back 5.
the buttocks If insulin needs to be administered three or more times a day then it's wise to rotate injection sites.
Injecting in the same place much of the time can cause hard lumps or extra fat deposits to develop.
Apart from being unsightly; they can also change the way insulin is absorbed, making it more difficult to keep your blood glucose within control.
Insulin is absorbed at different speeds depending on where you inject, so it's best to consistently use the same part of the body for each of your daily injections.
For eg.
if the abdomen has been used for the morning injections it is best to use the abdomen always for the morning doses, and to change this pattern every 2 weeks.
Tissues wise insulin absorption rates vary 21.
Fastest from the abdomen (stomach) 22.
Then from the arms 23.
Followed by the legs 24.
Slowest from the buttocks Unless advised otherwise, it is a good idea to inject breakfast and lunch bolus doses into the abdomen.
Insulin is absorbed fastest when injected into this area.
Fast absorption is needed at mealtimes to cover the carbohydrates..
Dinner or bedtime dose of long-acting insulin could be injected into the thigh, buttocks, or upper arm.
That's because the long-acting insulin should take effect gradually and control glucose throughout the night.
Other tips Monitor blood glucose levels carefully while injecting insulin.
Over time, it will be apparent which injection sites give you the best blood glucose control at different times of day.
Do not inject close to the belly button, moles or scars.
The tissue there is tougher, so the insulin absorption will not be as consistent.
If you inject in the upper arm, use only the outer back area (where the most fat is).
It is hard to pinch the upper arm when you are injecting yourself.
If you inject in the thigh, stay away from the inner thighs.
If your thighs rub together when you walk, if might make the injection site sore.
Do not inject in an area that will be exercised soon.
Exercising increases blood flow, which causes long-acting insulin to be absorbed at a rate that's faster than you need.
It might seem easier to find a spot that does not hurt and inject there all of the time.
However, the result could be unpleasant swelling and lumps.
You can reduce injection pain by choosing a needle length and gauge that are right for you.
Move to a new injection site every week or two.
Inject in the same area of the body, making sure to move around within that area with each injection, for one or two weeks.
Then move to another area of your body and repeat the process.
Use the same area for at least a week to avoid extreme blood sugar variations.
Rotate the sides (right, left) of your body where you inject within your injection sites.