Teach you the correct way to inject insulin

Now with the continuous development of the economy, the number of people suffering from diabetes is also increasing, and there is a trend of younger and younger people. If the medication does not control blood sugar well, doctors will often recommend that patients start injecting insulin to control blood sugar.

However, studies have shown that even patients who have used insulin for 3 months and 6 months have only 36.2% and 39.9% of their blood sugar levels reaching the target. Why is this? One of the important reasons is that patients do not have a good grasp of insulin injection techniques. Insulin injection techniques mainly include the following aspects:

1. Where exactly should the insulin needle be injected?
Generally speaking, suitable parts of the human body for insulin injection are the abdomen, outer thigh, outer upper arm and outer upper buttocks, but this is not a simple question of choosing one from four. When it comes to individual patients, we should consider more.
For example, if you are using short-acting insulin for mealtime injection, then you'd better choose the abdomen, because the abdomen absorbs the fastest, so as to effectively and timely control postprandial blood sugar; if you are using intermediate-acting or long-acting insulin, then you'd better choose the buttocks or thighs, because the buttocks and thighs absorb relatively slowly, which is more conducive to long-term blood sugar control.

But if you want to inject premixed insulin, such as insulin aspart 30 (NovoRapid 30R), protamine biosynthetic human insulin (Novolin 30R, Novolin 50R), protamine zinc recombinant lispro insulin mixed injection (Humalog 20R, Humalog 50R), protamine zinc recombinant human insulin mixed injection (Humalog 70/30), etc., the injection site should be adjusted according to the injection time. If you inject a regular premixed insulin preparation before breakfast, the preferred injection site should be the subcutaneous abdomen to speed up the absorption of regular (short-acting) insulin and facilitate the control of blood sugar fluctuations after breakfast; if you inject a premixed insulin preparation before dinner, the preferred injection site is preferably the subcutaneous buttocks or thighs to delay the absorption of intermediate-acting insulin and reduce the risk of nocturnal hypoglycemia, because hypoglycemia is often more harmful than hyperglycemia.

The absorption rate of ultra-short-acting (rapid-acting) insulin analogs (insulin aspart, insulin lispro) is not affected by the injection site and can be injected subcutaneously at any injection site; long-acting insulin analogs can also be injected at any common injection site, but intramuscular injection should be avoided to avoid severe hypoglycemia.
2. How to rotate the insulin injection sites?
The most common complications after insulin injection are local nodules and subcutaneous fat hyperplasia. The reason is that insulin is a growth factor that promotes synthesis. Therefore, long-term and repeated injections in the same area can easily lead to subcutaneous nodules. If insulin is continued to be injected in this area, the drug absorption rate will decrease, the absorption time will be prolonged, and blood sugar fluctuations will occur. Therefore, whether it is to control complications or to effectively control blood sugar, the rotation of injection sites is crucial.
But how should the rotation be done? There is currently a proven effective injection site rotation scheme: divide the injection site into four equal areas (the outer thigh or buttocks can be divided into two equal areas: upper and lower thigh, left and right buttocks), use one equal area per week and always rotate in a clockwise direction, and when injecting in any equal area, two consecutive injections should be systematically rotated in a way that is at least 1 cm (or about the width of an adult finger) apart to avoid repeated tissue trauma.
3. Do I need to pinch my skin for insulin injection? How do I do it?
Whether to pinch the skin should be considered comprehensively based on the patient's body shape, the thickness of the skin at the injection site, and the length of the needle. If the patient is obviously thin or the needle is long, it is best to pinch the skin to inject to avoid the risk of intramuscular injection. Once intramuscular injection occurs, the absorption characteristics of insulin will be completely different from subcutaneous injection: the insulin level will rise sharply, the peak will appear too early, the effect of insulin will disappear too quickly, and it will not last as long as it should, which may lead to frequent hypoglycemia. In short, when the estimated distance from the skin surface to the muscle is shorter than the length of the needle, the skin should be pinched to improve the safety of injection.
In addition, the technique of pinching the skin is also very important. The correct technique should be to use the thumb, index finger and middle finger to gently lift the skin, avoiding excessive force that may cause whitening of the skin and pain. Also, do not use the whole hand to pinch the skin to avoid pinching the subcutaneous muscles and causing intramuscular injection.

4. How to choose the needle insertion angle when injecting insulin?

The needle insertion angle can be divided into 90° injection and 45° injection. Regardless of the injection angle, the purpose is to ensure that the insulin is injected into the subcutaneous tissue. Generally speaking, when using a shorter needle (4 mm or 5 mm), most patients do not need to pinch the skin and the needle can be inserted at 90°; when using a longer needle (≥6 mm), it is necessary to pinch the skin and (or) insert the needle at 45° to increase the thickness of the subcutaneous tissue and reduce the risk of intramuscular injection.
5. How long should the insulin needle remain in place?
In clinical practice, it is found that after the insulin pen is used for injection and the needle is removed, the needle may leak, resulting in reduced insulin utilization, thus affecting blood sugar control. This is because the needle is not kept for enough time before being removed. It is recommended that after fully pressing the thumb button when using an insulin pen for injection, the needle should be kept for at least 10 seconds before being removed to ensure that all the medicine is injected into the body and to prevent leakage of the medicine. When the drug dose is large, it is necessary to exceed 10 seconds; unlike an insulin injection pen, if a dedicated insulin syringe is used to inject insulin, the syringe plug can be removed after being pushed into place, and it does not need to be kept under the skin for 10 seconds before being removed.

6. Can I get another shot after having had it injected once?
Due to economic constraints or for the sake of convenience, the phenomenon of reusing needles is very common among diabetic patients in my country. However, contrary to expectations, there are too many hidden dangers in reusing needles:
1. The residual liquid in the needle will affect the accuracy of the injection dose;
2. The insulin remaining in the needle after use forms crystals, which will clog the needle and hinder injection;
3. The needle remains on the insulin pen after injection, which may cause inaccurate insulin injection dosage due to thermal expansion and contraction;
4. Needle reuse is associated with lipohypertrophy, that is, the more times the needle is reused, the higher the prevalence of lipohypertrophy;
5. Repeated use of injection needles will cause needle tip blunting, damaged cut surface, and shedding of the lubricating layer on the needle surface, increasing pain and directly affecting patient compliance;
6. There were fewer bacteria on needles that had been used once than on reused needles, and inflammatory changes (redness of the skin) were only found at the injection site in patients who reused needles.
The above hidden dangers will eventually affect the patient's blood sugar control.

Finally, if you have diabetes in your family, remember:

There are thousands of factors that affect blood sugar.

Safety injection first.

Improper injection,

Two lines of tears for loved ones.