Technique for the administration of insulin: an algorithm of actions, features and recommendations

Insulin is a pancreatic hormone that regulates the process of carbohydrate metabolism in the body. With its lack, the blood sugar level rises, which leads to a pathological serious condition. Fortunately, for modern people, diabetes is not a sentence. The amount of insulin is regulated by special injections. This is the main treatment for type I and sometimes type II diabetes. The dosage calculation is made individually for each patient, but the technique of administering insulin is the same for everyone, and we will get to know you in the article.

Why do we need injections?

For various reasons, the pancreas begins to work incorrectly. Most often this is expressed in a decrease in the production of the hormone insulin, which, in turn, leads to disruption of the digestive and metabolic processes. The body becomes unable to receive energy from the consumed food and suffers from an excess of glucose, which, instead of being absorbed by the cells, accumulates in the blood. When this condition occurs, the pancreas receives a signal about the need for insulin synthesis. But due to malfunctioning of the body, the hormone is excreted in negligible amounts. The condition worsens, while the amount of intrinsic insulin in the meantime tends to zero.

Correcting the situation is possible only by supplying the cells with an analog of the hormone. Therapy continues for life. A patient with diabetes daily performs injections several times. It is important to do them in a timely manner, in order to avoid critical conditions. Insulin therapy allows you to control blood sugar and maintain the pancreas and other organs at the proper level.

General injection rules

The technique of administering insulin is the first thing that patients are taught after they detect diabetes. The procedure is simple, but requires basic skills and understanding of the process. A prerequisite is compliance with the rules of asepsis and antiseptics, i.e., the sterility of the procedure. To do this, remember the following standard sanitary standards:

• hands should be washed before the procedure;
• the injection area is wiped with a damp clean cloth or antiseptic;
• For injection use special disposable syringes and needles.

At this stage, you should know that alcohol destroys insulin. When treating the skin with this product, it is necessary to wait for its complete evaporation, and then proceed to the procedure.

Typically, insulin is administered 30 minutes before a meal. The doctor, based on the characteristics of the prescribed synthetic hormone and the patient's condition, will give individual recommendations on the doses of the medicine. Usually, two types of drug are used during the day: with a short or prolonged effect. The technique of insulin administration is somewhat different.

Where do they put the injection?

Any injection involves certain places recommended for its effective and safe conduct. An injection of insulin cannot be attributed to either the intramuscular or intracutaneous type of administration. The active substance must be delivered to the subcutaneous fat. When insulin enters muscle tissue, its action is unpredictable, and the sensations during the injection are painful. Therefore, the injection can not be put anywhere: it just does not work, which will significantly worsen the condition of the patient.

The technique of insulin administration involves the use of the following parts of the body:

• front upper thigh;
• the stomach (the area near the navel);
• the outer fold of the buttocks;
• shoulder.

Moreover, for independent injection, the most convenient places are the hips and abdomen. These two zones are for different types of insulin. Sustained-release injections are preferably placed in the hips, and fast-acting injections in the navel or shoulder.

What is the reason for this? Experts say that slow absorption occurs in the subcutaneous fatty tissue of the thighs and the outer folds of the buttocks. Just what you need for long-acting insulin. And, on the contrary, almost instantly when the cells of the body receive the introduced substance, they occur in the abdomen and shoulders.

What injection sites are best excluded?

Clear guidelines must be followed regarding the choice of injection site. They can only be the places listed above. Moreover, if the patient performs the injection on his own, it is better to choose the front of the thigh for a long-acting substance, and the stomach for ultra-short and short insulin analogues. This is because administering the drug to the shoulder or buttocks can be difficult. Often, patients are unable to independently form a skin fold in these areas to get into the subcutaneous fat layer. As a result, the drug is mistakenly injected into muscle tissue, which does not improve the condition of the diabetic.

Avoid areas of lipodystrophy (areas with a lack of subcutaneous fat) and deviate from the site of the previous injection about 2 cm. Injections are not injected into inflamed or healed skin. To exclude these unfavorable places for the procedure, make sure that there are no redness, seals, scars, bruises, signs of mechanical damage to the skin on the planned injection site.

How to change the injection site?

Most diabetics are insulin dependent. This means that every day they have to carry out several injections of the drug in order to feel good. At the same time, the injection zone must constantly change: this is the technique for administering insulin. The algorithm of the performed actions involves three scenarios:

1. Conducting an injection near the site of the previous injection, retreating from it about 2 cm.
2. Division of the administration area into 4 parts. During the week, use one of them, then move on to the next. This allows the skin of other areas to rest and recover. A distance of several centimeters is also maintained from the injection sites in one lobe.
3. Divide the selected area in half and chop alternately into each of them.

The technique of subcutaneous administration of insulin allows you to deliver the active substance into the body at the required speed. Because of this, one should adhere to constancy in the choice of area. For example, if a drug of prolonged action, the patient began to enter the hips, then there must continue. Otherwise, the rate of absorption of insulin will be different, which ultimately leads to fluctuations in blood sugar levels.

Calculation of the dose of the drug for adults

The selection of insulin is a purely individual procedure. The daily amount of recommended units of the drug is influenced by different indicators, including body weight and the "experience" of the disease. Experts have found that in the general case, the daily requirement of a patient with diabetes in insulin does not exceed 1 unit per 1 kg of his body weight. If this threshold is exceeded, complications develop.

The general formula for calculating the dosage of insulin is as follows:

D _day × M, where:

• D _day - the daily dose of the drug;
• M is the patient’s body weight.

As can be seen from the formula, the technique for calculating insulin administration is based on the size of the body's need for insulin and the patient’s body weight. The first indicator is established based on the severity of the disease, the age of the patient and the "experience" of diabetes.

Having found out the daily dose, a calculation is made. One-time diabetes can be administered no more than 40 units, and within a day - within 70-80 units.

Insulin Dose Calculation Example

Suppose a diabetic’s body weight is 85 kg, and D _day is 0.8 U / kg. Perform calculations: 85 × 0.8 = 68 PIECES. This is the total amount of insulin needed by the patient per day. To calculate the dosage of long-acting drugs, the resulting number is divided into two: 68 ÷ 2 = 34 PIECES. Doses are distributed between morning and evening injection in a ratio of 2 to 1. In this case, 22 units and 12 units will be obtained.

On the "short" insulin remains 34 units (out of 68 daily). It is divided into 3 consecutive injections before meals, depending on the planned amount of carbohydrate intake, or is divided portionwise, accounting for 40% in the morning and 30% for lunch and evening. In this case, the diabetic will introduce 14 units before breakfast and 10 units before lunch and dinner.

Other insulin therapy regimens are possible, in which prolonged-acting insulin will be greater than “short”. In any case, the calculation of doses should be supported by measuring blood sugar and careful monitoring of well-being.

Dosage calculation for children

The body of the child requires much more insulin than the adult. This is due to intensive growth and development. In the first years after the diagnosis of the disease, an average of 0.5–0.6 PIECES per kilogram of the child’s body weight After 5 years, the dosage usually increases to 1 U / kg. And this is not the limit: in adolescence, the body may require up to 1.5–2 units / kg. Subsequently, the value is reduced to 1 unit. However, with prolonged decompensation of diabetes, the need for insulin administration increases to 3 U / kg. The value is gradually reduced, bringing to the original.

With age, the ratio of the hormone of long and short action also changes: in children under 5 years of age, the amount of the drug of prolonged action prevails, by adolescence it decreases significantly. In general, the technique for administering insulin to children is no different from administering an injection to an adult. The difference is only in daily and single doses, as well as the type of needle.

How to make an injection with an insulin syringe?

Depending on the form of the drug, diabetics use special syringes or syringe pens. On the cylinders of insulin syringes there is a division scale, the price of which for adults should be 1 unit, and for children - 0.5 unit. Before the injection, it is necessary to perform a series of sequential steps, which are prescribed by the technique of administering insulin. The algorithm for using an insulin syringe is as follows:

1. Wipe your hands with an antiseptic, prepare a syringe and take air into it to the mark of the planned number of units.
2. Insert the needle into the vial of insulin and release air into it. Then, draw a little more than necessary into the syringe.
3. Tap on the syringe to remove bubbles. Release excess insulin back into the vial.
4. Bare the injection site, wipe with a damp cloth or antiseptic. Form a crease (not required for short needles). Insert the needle at the base of the skin fold at an angle of 45 ° or 90 ° to the skin surface. Without releasing the crease, push the piston all the way.
5. After 10-15 seconds, release the fold, remove the needle.

If it is necessary to mix NPH-insulin, the medicine is collected according to the same principle from different bottles, first letting air into each of them. The technique of administering insulin to children suggests an identical algorithm of action.

Syringe Injection

Modern drugs for regulating blood sugar levels are often produced in special syringe pens. They are disposable or reusable with interchangeable needles and differ in the dosage of one division. The technique of subcutaneous administration of insulin, the algorithm of actions involves the following:

• mix insulin if necessary (twist in the palms of your hands or lower your hand with a syringe from shoulder height down);
• release 1–2 units into the air to check the patency of the needle;
• twisting the roller at the end of the syringe, set the required dose;
• to form a fold and make an injection similarly to the technique of introducing an insulin syringe;
• after administration of the drug, wait 10 seconds and remove the needle;
• close it with a cap, scroll and throw it away (disposable needles);
• close the syringe pen.

Similar actions are performed to inject children.

Diabetes mellitus is a serious disease that requires constant monitoring of blood sugar and its regulation with injections with insulin. The injection technique is simple and accessible to everyone: the main thing is to remember the injection site. The basic rule is to get into the subcutaneous fat, forming a fold on the skin. Insert the needle into it at an angle of 45 ° or perpendicular to the surface and press the piston. The procedure is simpler and faster than reading the instructions for its implementation.