Press your injection site with your fi nger for 510 seconds to keep insulin from leaking out. If you are using a cloudy insulin, gently roll the pen between your hands to mix the insulin. Remove at the same 90degree angle at which you inserted the needle. It has been developed to be a practical, clear and concise document to inform evidencebased best practice in injection technique with the aim to increase knowledge and skills to improve health outcomes as a result of optimal insulin and glp1 receptor agonist delivery. Apply slight pressure for 58 seconds, but do not rub the site. Injecting into the same spot too oft en can cause skin problems and can impair insulin absorption. Choose age appropriate sites for injection demonstrate correct injection technique using insulin 4. If you plan to change your technique, check with your healthcare team, diabetic nurse or consultant for their advice.
If the child or young person does not have much fat, some of these sites may not be suitable. Ensuring that people with diabetes use correct injection techniques for insulin therapy is a vital part of nurses role. Results and analysis of the 20082009 insulin injection technique. Pdf can a faulty injection technique lead to a localized. Officially launched at diabetes professional care 2018, injection technique matters is on a mission to spread good practice. It is important that a new pen needle is used with each injection.
Your diabetes nurse educator can advise you on the appropriate needle length and show you correct injection technique. Insulin is injected subcutaneously, which means into the fat layer under the skin. Subcutaneous injection technique for insulin and glucagonlike peptide 1 adea 2011. To locate injection sites on the arms, fold one arm across the chest. Hold the syringe at a 90degree angle to the skin, and push the needle all the way in. This injection technique guideline for diabetes educators and healthcare. The presence of lipohypertrophy at an insulin site indicates that another site should be. An insulin pump is a small programmable device that holds a reservoir of insulin and is worn outside the body.
These evidencebased recommendations will help guide the education of patients and health care professionals to deliver safe and effective injections. An abridged version of the fit first indian insulin injection technique recommendations was published. It is important for each person to use the needle length and injection technique that best suits their needs. Who best practices for injections and related procedures toolkit. If your insulin contains zinc or isophane normally cloudy, be sure that it is completely mixed. Jan 29, 2009 this is an instructional video only and not a substitute for personal medical care. Prevalence and risk factors of lipohypertrophy in insulininjecting. American association of diabetes educators june 20 for people with diabetes who use insulin or other injectable medications, the diabetes educator can enhance and improve patient engagement to maximize clinical outcomes by mitigating injection concerns and teaching methods to maximize insulin absorption and action while reducing discomfort. Optimizing insulin injection expert recommendations from. Once you are at home, refer to this booklet and the notes that have been made to remind yourself of any aspect of your care. Provides 24hour insulin coverage and may be given 1 to 2 times per day. If insulin gets too hot or too cold it will not be as effective when you inject it.
There are different sizes and lengths of needle tips available. Insulin injection technique depth ofinjection is important formanyyears after the introduction ofinsulin the recom. Diabetes care in the uk fit uk forum for injection. Recommended sites for injection take into account that most of the time the therapeutic agent is being selfinjected except in children and people with disabilities. Insulin syringes and pen needles are designed to be used once. Improving your insulin injection technique the way that you insert your syringe or pen needle into your skin in order to get a proper dosage of insulin is called your insulin injection technique. Cover the injection site with your finger or a cotton ball or gauze. Optimizing insulin injection technique and its effect on blood glucose control article pdf available in journal of clinical and translational endocrinology 14 december 2014 with 675 reads. These include the ability to selfinject insulin safely using a syringe or insulin pen. Insert the needle into the middle third of the muscle parallel to the surface on which the patient is lying. When using a pen or vial for the first time, take it out of the fridge a half hour early so that it has time to warm up to room temperature. Importance of injection technique in diabetes choosing the correct site the subcutaneous tissue is quite easy to reach from all injection sites on the body surface. Diabetes care in the uk the first uk injection technique.
The efficacy of injection therapy in diabetes depends on. Pdf insulin internalizes glut2 in the enterocytes of. The patch holds a small reservoir and a prefilled needle. Stay 1 inch away from the last few injection sites. Unlike traditional insulin pumps, this device is a creditcard size device that adheres to the skin. Barriers, solutions to insulin injection therapy for type 2. It is not intended as a substitute for medical education or training. From this meeting a consensus was reached to establish the international injection technique recommendations. In this article barbara workman describes the correct technique for safe intradermal, subcutaneous and intramuscular injections. Injection technique is critical to the therapeutic success of insulin. Fit was established following the 3rd international injection technique meeting athens 2009. Giving yourself an insulin injection with the lantus. In the absence of specific guidelines on insulin therapy for the region, the health care providers may not be in position to give detailed instructions to patients on proper injection techniques, and therefore there is an urgent need for guidelines on insulin storage and optimisation of injection technique in diabetes management, focusing on. Onethird of those taking insulin have nodules or bumps in the fat tissue at their injection sites a condition known as lipohypertrophy, or lipos.
To draw the insulin up into the syringe correctly, you need to follow these steps. Remove all air bubbles from the syringe before the injection. Your doctor will tell you how much insulin to take and how often to take it. Combining paired st and sct measurements n 1,208 for.
Clinical guiding principles for subcutaneous injection. New delivery devices and tools, such as insulin pens and refined, shorter needles, are being introduced to provide ease, limit pain and to help overcome many of. Intramuscular risk at insulin injection sitesmeasurement of the. Write down how much insulin you injected, the time of day, and site. Injection technique in insulin therapy nursing times. Injection of insulin is triggered by pressing a button on the patch. Place your hand on the shoulder and draw an imaginary. Teaching injection technique to people with diabetes. Since incorrect or inaccurate self injection of insulin may bring about poor diabetic control and hypoglycemia, adequate coaching in the injection technique is vital 6. Subcutaneous insulin injection technique the aim of this article is to update general nurses knowledge of insulin injections. Who best practices for injections and related procedures. For example, if you choose to use your abdomen, rotate injection. See diagrams for possible injection sites abdomen, upperouter buttocks, upperouter thighs, upperouter arms.
Your nurse or doctor will show you how to use your personal pen device to inject. Recommendations for best practice in injection technique october 2011. However it may in certain cases be just as important to diabetes management as the type of insulin or dosage used. By learning to use the proper technique, you can give yourself injections quickly, accurately and with a minimum of discomfort and inconvenience. Insulin injection tips if your treatment plan includes injection therapy, it is especially important to follow a healthy injection routine, including proper site selection, rotation and injection technique. It is really important to store insulin at the right temperature. Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections.
Pdf optimizing insulin injection technique and its effect. You can inject the insulin into your stomach belly or the top of your thigh. By sticking with a healthy injection routine, your injections may be less painful and you can reduce your risk of developing complications like. Dose, dilution, reconstitution, and injection techniques. Stay 2 inches away from the belly button navel and any scars. Insulin can only be given by injections, also called shots. For specific guidance on giving an insulin injection, talk with your doctor. If you, or a loved one, has diabetes and has been prescribed insulin, its natural to be nervous about injecting insulin for the first time. Potential insulin injection sites include the abdomen, thighs, buttocks or arms. Because you will be injecting insulin on a regular basis for diabetes, you need to know where to inject it and how to rotate move your injection sites. How to give an insulin injection for parents nemours. Expert recommendations on injecting insulin with pen and. Every time you inject insulin into body fat or muscle, its important to ensure that the area is clean and that you are using a clean syringe or insulin pen.
Diabetes nurses and observant patients have long known that the technique of injection is critical to the successful use of insulin, but the medical community at large and most insulin injecting patients remain woefully. Injection sites should be inspected routinely for these lumps something the injection technique questionnaire indicates is not happening, both by oneself and by a healthcare provider. Jul 07, 1990 vaag a, pedersen kd, lauritzen m, hildebrandt p, becknielsen h. If you clean your skin with an alcohol pad, wait until it has dried before you inject insulin. According to a study, correct injection technique and use of shorter needles 4 mm are associated with improved glucose control, greater satisfaction with therapy and lower consumption of insulin after only a 3month period.
They contain insulin instead of ink and have a dial for setting the dose. Your nurse or doctor will help you select the best sites to administer your medication. Nsw adult subcutaneous insulin prescribing chart user guide. If lines are both above and below the lateral canthus. Several factors influence the success of insulin injection therapy, injection technique being highly variable and operatordependent. The document applies to adult patients in acute care inpatient settings. Proper injection technique is essential for optimal function. Improper use or reuse of injection devices may lead to undesirable consequences. Forum for injection technique, and fully support the continued work of the fit board and fit associates who continue to expand the boundaries of best practice within the fields of insulin injection and medication management. Once you have started using a vial of insulin, it can be kept at room temperature for a month. Injection technique injecting insulin with a pen injecting insulin with a pen.
The first insulin pen was manufactured by novonordisk in 1985. It is the first device to combine an injection port and an inserter in one complete set that. Insulin that is cloudy nph, premixed needs to be mixed before using. Rotate the sides right, left of your body where you inject within. Injections products insulin is given by subcutaneous injection. In this type of injection, a short needle is used to inject insulin into the fatty layer between the skin and the. But, with a little practice youll discover it only. The text of the second edition has been revised to a minor extent and the bibliography has been. However, there appears to be a lack of evidencebased consensus over needle length and, indeed. Insulin can be injected using either an insulin pen or a syringe and vial. Your healthcare professional can help you to learn an injection technique that will make your insulin therapy as effective and successful as possible.
In the survey, almost one in three participants appeared to have lipohypertrophy other studies show prevalence up to, and beyond, 50%. Mayo clinic proceedings publishes new insulin injection and. If the insulin has been stored in the refrigerator, remove it 30 minutes before you inject it. Unlike injections with pen needles, insulin syringe users dont need to hold the needle in the skin for 10 seconds after injection before removing it. Continuing professional development injection management. Insulin and other injected diabetes medications are meant to be deliv ered into the fat layer just under the skin.
Talk with your healthcare professional about which needle tip would be best for you. Though faulty injection technique is a simple and easily treatable cause of injection site allergy in insulin treated diabetics, it is often overlooked in clinical practice. There are various insulin regimens available, such as basal only, basalbolus and mixed insulin. Subcutaneous administration of insulin in adults with type. Best practice guideline to support correct injection. If using a syringe, keep the needle in the skin for 5 seconds. Insulin is the main injectable therapy used by people with diabetes, but often they do not receive adequate education on injection technique. Let go of the pinched skin, and slowly push the plunger to inject all of the insulin. This therapy is obligatory for individuals with ketoacidosis and it can be taken into consideration for all.
These evidencebased recommendations will help guide the education. Ours is the first study to combine the patients reporting with. Many patients taking insulin are using needles that are longer and thicker than recommended, and are reusing the needles frequently. Until recently, many of the recommendations on insulin administration, globally, had little or no scienti. Injection techniques injections should be given with the needle bevel tip up and oriented away from the eye1 inject 4 units0. Forum for injection technique fit, india recommendations. There is only one such device on the marketthe vgo. When your body doesnt make enough insulin, or it cant effectively use the insulin it does produce, your healthcare professional may prescribe insulin therapy. Proper injection remains critical to the delivery of diabetes care. Best practice guideline to support correct injection technique in diabetes care page 7 health professionals must teach best practice injection technique when insulin and glp1 ras are initiated including.
Gently clean your skin with an alcohol swab at the site selected for injection. Clean the top of the insulin vial before drawing up your dose of insulin. Intraperitoneal insulin injections performed 20 min be fore the fructose test meal produced a threefold elevation of plasma insulin range 1. There are several important steps that will help you successfully prepare your insulin injection. If you think you are injecting into the muscle, you may want to change your technique or ask your gp to prescribe shorter needles the steps below are a broad guide to injecting insulin.
Nov 04, 2014 insulin injection technique for diabetics in hindi dr. Appropriate injection technique, thus, is an indispensable part of diabetes management. Forum for injection technique fit, india the forum for injection. Injecting regularly with the right technique ensures the insulin can work properly. Insulin is always used for the treatment of insulindependent diabetes mellitus type i diabetes and occasionally also for the treatment of therapy refractory noninsulindependent diabetes mellitus type ii. The needle is injected into the fatty tissue just below the skin layer and above the muscle layer. When you are injecting insulin, you should aim to inject into the fatty tissue just underneath the skin. Giving a subcutaneous injection locating injection sites subcutaneous injections can be given in the arms, legs, or abdomen. New clinical recommendations for insulin injection and. The steps below are a broad guide to injecting insulin. Injection technique in insulin therapy request pdf.
Good injection technique ensures that you get the most out of your injectable therapy and achieve the best blood glucose control possible while avoiding complications associated with poor injection technique. Teaching objectives identify age appropriate injection site instruct injection technique 3. Please take guidance from parents on appropriate injection sites. A disposable pen needle is attached to the end of the pen prior to injecting. Many different people with different types of diabetes need to inject themselves with insulin. A skin lift may be warranted to prevent an intramuscular im injection in a slim limb or abdomen, even when a shorter needle is used. If you had it in the refrigerator or cooler bag, take it out 30 minutes before the injection.
Popular injection sites include the abdomen staying two fi ngers or a few inches away from the belly button, outer thighs, hips, upper buttocks, lower back, and backs of the arms. Wait about 5 seconds before pulling out the needle. Find patient medical information for insulin regular human injection on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. If using a pen, keep the needle in the skin for 10 seconds.
Data from this global injection technique survey was shared during the forum for injection technique and therapy. Most physician visits with insulin injecting patients involve discussions about glucose control and dose adjustments, but very little time is spent on improving injection technique it. The importance of choosing the optimal injection site for the prescribed insulin regimen and matching the site with the needle length and injection technique is discussed. Use alcohol to clean the end of the pen where the needle twists on. Evidencebased clinical guidelines for injection of. Store unopened insulin and glp1 ra in the fridge, as per manufacturers instructions at 48 degrees. Pinch your skin gently at the site selected for injection. Optimizing insulin injection technique and its effect on. Intramuscular versus subcutaneous injection of unmodified insulin.
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