"Hypoglycemia & insulin devices" Information from the national institute of diabetes and digestive kidney diseases.
Insulin is a hormone that helps glucose get inside your body’s cells. Your cells use glucose for energy. If you have type 1 diabetes, your pancreas no longer makes insulin, or it makes only a tiny amount. If you have type 2 diabetes, your pancreas still makes insulin, but it doesn’t make enough, or your body has a hard time using the insulin or both.
What the bottle tells you
Besides insulin, bottles contain very pure water. Substances such as zinc may have also been added. These allow you to control how fast and how long the insulin will work.
On the labels you’ll see some of the following big letters describing the type of insulin. Here’s what they mean:
R: Short - acting insulin. It starts controlling blood sugar fast (within 1/2 hour) but stops working sooner than other types of insulin.
N or L: Intermediate - acting insulin. It starts working within 1 hour, works hardest in 6 to 10 hours, and lasts about a day. It’s milky, not clear, because a substance has been added to slow it down. You need to mix it (by rolling, not shaking) before you use it.
U - Longest - acting insulin. It starts working in 3 to 6 hours and lasts for more than a day. It’s milky looking, too.
Insulin strength
The mixtures come in different strengths. Most people use U-100 insulin. This means that there are 100 units of insulin per milliliter of fluid. If you inject insulin, it is important to use a syringe that matches the strength of your insulin. For instance, if you use U-100 insulin, use a U-100 syringe.
Syringes
Syringes come in several sizes and with different dosage markings on the barrel. They should be chosen according to the strength of prescribed insulin. Some syringes have both whole-unit and half-unit markings on the barrel. Syringes also vary in the readability of barrel markings, the color of the plunger, packaging, and cost.
Insulin pens
Other methods of insulin delivery are available. The insulin pen contains a replaceable insulin cartridge (good for 21 days) and a disposable needle. The benefits are that you can use it discreetly and it provides accurate dosing of insulin.
Insulin shots
Insulin cannot be taken in a pill. It would be broken down like food before it could work. Insulin needs to be injected under the skin, in the fat, to work well. Injecting into fat is much less painful than injecting into muscle. Besides, if you inject into muscle, the insulin will not work as well. Usually it will work too fast.
Where to give yourself a shot
There are four good areas for insulin shots:
1. Your abdomen (anywhere except within 2 inches of the navel)
2. Your upper arms (outside part)
3. Your buttocks (anywhere)
4. Your thighs (front and outside parts, not inner thigh, not just above your knee)
These areas absorb insulin at different speeds. Your abdomen absorbs insulin faster. Your upper arms absorb insulin more slowly. Your buttocks and thighs absorb insulin even more slowly. Depending on where you inject your insulin, it may act faster or slower. This can affect your blood glucose control.
Points to remember
- Avoid areas with scars and stretch marks
- Ask your doctor or nurse to check your skin where you give your shots
You may prefer to take your shot in the same area so that you know how it will act. Some doctors suggest that you take all your shots in the abdomen. Others suggest that you choose your area according to how fast or slow you want the insulin to start working.
Sites
Pretend that each area is covered with circles that are 1 inch apart. Each circle is one site. The number of sites you have depends on how big your body is. Within each area, it is best to change sites with each shot. This is called rotation. To rotate sites, you use a different circle for each shot until all the circles have been used up. Then you start all over again. If you take all your shots in the same place, you can damage the tissue under your skin.
Tips on making the shot more comfortable
Insulin shot
- Inject insulin at room temperature. Using cold insulin right from the refrigerator may make the shot hurt more.
- Make sure there are no air bubbles in the syringe before you inject the insulin.
- Wait until the alcohol you put on your skin is dry (if used).
- Relax your muscles in the area.
- Puncture the skin quickly.
- Keep the needle in the same direction when you put it in and take it out.
- Use sharp, not dull needles.
Lancet stick
- Clean hands with warm soap water.
- Make sure your hands are warm.
- Massage the selected finger, moving from the hand towards the tip (don’t touch the puncture site).
- Lance the side of the finger, not the middle. Always rotate sites.
Hypoglycemia
The aim of treatment in diabetes is to lower high blood sugar levels. To do this, people with diabetes may use insulin or oral drugs, depending on the type of diabetes they have or the severity of their condition. Hypoglycemia occurs most often in people with type 1 diabetes and some people with type 2 who use insulin. People with type 2 who take oral drugs called sulfonylureas are also vulnerable to low blood sugar episodes.
Conditions that can lead to hypoglycemia include:
- Taking too much medication
- Missing or delaying a meal
- Eating too little food for the amount of insulin taken
- Exercising too strenuously
- Drinking too much alcohol, or any combination of these factors
Insulin devices available
Insulin pens can be helpful if you take at least three doses of insulin a day and want the convenience of carrying insulin with you. An insulin pen is a device that looks like a pen with a cartridge that holds 100 to 200 units of insulin.
A fine, short needle, similar to the needle on an insulin syringe, is on the tip of the pen. Users turn a dial to select the desired dose of insulin and press a plunger on the end to deliver the insulin just under the skin.
Insulin jet injectors, which look like large pens, send a fine spray of insulin through the skin by a high-pressure air mechanism. External insulin pumps attach to the body through narrow, flexible plastic tubing, with a needle inserted just under the skin near the abdomen. The insulin pump can be worn on a belt or in a pocket. A refillable cartridge holds enough insulin for about 2 days.
