How to use insulin and what are the precautions for use

Insulin is a common hypoglycemic drug. Since its introduction, it has played an important role in controlling blood sugar and improving the prognosis of diabetic patients. However, many patients often neglect some details when using and storing insulin, which affects the hypoglycemic effect of insulin. Liu Wei, a pharmacy expert, introduces the precautions for the use and storage of insulin to help everyone use insulin correctly.

Precautions for using insulin

1. Dosage time Generally, short-acting insulin should be injected 30 minutes before meals, and medium-acting and long-acting insulin should be injected 40 to 60 minutes before meals. Short-acting insulin should be injected 3 to 4 times a day, medium-acting insulin should be injected twice a day, and long-acting insulin should be injected once a day.

2. The injection site should be selected in a place with abundant subcutaneous fat and without many nerves and blood vessels. Suitable injection sites are the abdomen, outer thigh, outer upper arm and outer upper buttocks. The injection site should follow the rotation rule, alternate different injection sites, and rotate within the same injection site. Divide the injection site into multiple areas, use one area per week, and always rotate in the same direction (such as clockwise); when injecting in the same area, there should be at least 1 cm between two consecutive injections; injections in the same site between different injection sites should preferably be spaced at least 1 month apart.

3. Before injection, check whether the insulin has changed color, or whether there are lumps or flocs; the injection site should avoid areas with subcutaneous fat hyperplasia, inflammation, edema, ulcers or infection; when using premixed insulin, it should be shaken slowly back and forth for more than 10 times until a uniform white suspension appears. Violent shaking is prohibited; when making homemade mixed insulin, the short-acting insulin should be drawn out first, then the long-acting insulin, and then mixed. The operation cannot be reversed.

4. When injecting, choose the appropriate insulin needle according to the thickness of the patient's subcutaneous fat. Pregnant women and young children should choose a 4 mm injection needle; after the injection, stay for more than 10 seconds before pulling out the needle. If the injection is done by pinching the skin, the needle should be pulled out first and then the skin should be loosened; if the single injection dose is greater than 40U, it should be injected in two times.

5. The needle used after injection is considered a medically contaminated sharp object. You should put the outer needle cap on the needle with one hand and unscrew it and put it into the sharps box or use a needle remover to remove the needle to avoid hurting others. After injecting insulin, avoid doing various housework while waiting for meals to avoid excessive exercise leading to hypoglycemia, and do not forget or delay meals.

6. Adverse reactions ① Hypoglycemia: may be related to excessive insulin dosage, reduced diet, increased exercise, and drinking, especially drinking on an empty stomach. Patients should eat regularly and quantitatively, add extra carbohydrates before exercise, avoid alcoholism and drinking on an empty stomach; ② Allergies: manifested as itching and rash at the injection site. At this time, insulin needs to be replaced with a higher purity insulin, and antihistamines should be used locally to prevent allergies. In severe cases, insulin treatment needs to be interrupted as appropriate; ③ Atrophy or hyperplasia of subcutaneous fat at the injection site: it can recover slowly after stopping the injection of this site; ④ Pain: pain may be caused by touching the subcutaneous nerve when the needle is inserted. At this time, the site can be changed and injected again.

Insulin storage precautions

1. Unopened insulin: should be refrigerated in a refrigerator at 2-8°C. Remember not to put insulin in the freezer of the refrigerator, and do not place insulin deep in the refrigerator against the inner wall. When the temperature is below 2°C, insulin will crystallize and lose its biological effect. Insulin can be stored in the refrigerator until the expiration date, and should be discarded after the expiration date.

2. Opened insulin: Opened insulin cannot be put back into the refrigerator. It should be stored at room temperature (25°C), dry and away from light. Keep away from heat sources such as electric heating tables, hot drinks, computers and other heat-generating items. Please be sure to mark the opening time on the insulin bottle. If it exceeds 4 weeks, it should be discarded.

3. Insulin preparation: In order to reduce the pain during injection, insulin should be taken out of the refrigerator in advance and placed at room temperature for 30 to 60 minutes until the insulin reaches room temperature before injection.

4. Notes during travel: When traveling or on a business trip, if there is no refrigerator due to limited conditions, you can store insulin in an insulin refrigerated box, or in a cool, dark place; when flying, you cannot put insulin in checked luggage, as the temperature in the checked luggage compartment is often below zero, which will freeze and denature the insulin, so it should be carried with you; when riding in a car, you cannot put insulin around the car's radiator or in the trunk.