How to use an insulin injection pen:
Insulin pen has the advantages of accurate injection dosage, simple operation, convenient carrying and storage, etc. It is especially suitable for diabetic patients to inject themselves at home. The following is an introduction to the correct use of insulin pens and related precautions.
Preparation before injection: Instruct patients to choose the injection time according to the action characteristics of the insulin dosage form used by them, wash hands before injection, and check the dosage form of the refill, the quality of the liquid and the refill with or without breakage, and then load the refill in the insulin pen, sterilise the soft-skin plugs, install the needles, premixed insulin or intermediate- or long-acting insulin, turn the pen up and down, and shake the liquid well. When exhausting the pen up, the needle up, its flick quill frame, mobilise the dose selection button, adjust 2 units of insulin, and then pushed to the 0 position, and until there is a drop of insulin drop appeared in the needle, otherwise repeat the above operation. Air bubbles in the cartridge will result in a longer injection time for the same dose of insulin. Exhaust the air and adjust to the desired dose.
Selection and rotation of injection site: select upper arm, anterolateral thigh, buttock, abdomen, no injection within 5cm around the umbilicus, according to the speed of absorption in the order of abdomen, upper arm, thigh, buttock, avoid repeated use of the same injection site within 1 month, two horizontal fingers between two injection sites. Absorption is accelerated when exercising, so avoid injecting in the exercising limbs if exercising.
Insulin injection: the injection site with alcohol swabs to disinfect the skin, the correct method of disinfection with alcohol cotton balls to the injection point as the centre, from the middle to the surrounding circular disinfection of the skin, the diameter of about 5cm or so. To be volatile after the hand pinch up or press the skin to fix the injection site, the injection needle and the skin at an angle of 90‘angle piercing, press the dose adjustment button to inject insulin, Novo pen, see the dose unit to return to the “0”, Dongbao electronic pen to the injection when you hear the “ka-da” sound in the skin.sound in the skin after about 10 seconds (can be counted from 1 to 15 after injection) and then withdraw the needle, with a sterile cotton swab gently press the injection site for a few seconds, be careful not to massage in order to avoid damage to the subcutaneous tissues or cause insulin leakage.
Disposal after injection: After injection, unscrew the needle to avoid puncture wounds, put the discarded needle into the designated location and dispose of it centrally. Put back the cap. Be careful not to reuse the needle, and systematically change the injection site, so as not to cause local hardness, affecting absorption and efficacy.
Care of insulin injection pens in application
1.Dietary care: low sugar and low protein diet. Daily carbohydrates account for 50%~65% of total calories, fat accounts for 25%~30% of total calories, protein accounts for less than 15% of total calories, the daily amount of salt is less than 6g, three meals a day should be strictly controlled, if not enough to eat can be supplemented with vegetables, do not eat snacks, fried foods, fruits with high sugar content. Limit alcohol consumption, it is better to give up alcohol, because alcohol can accelerate the breakdown of insulin and cause hypoglycaemia. Eat on time, 30min after insulin injection, otherwise hyperglycaemia or hypoglycaemia will occur.
2. Skin care of injection site:
(1) Observe the colour of local skin before injection, whether there is any bump, redness and swelling (individuals have insulin allergy) whether there are small bleeding spots. If there is occasional bleeding in the muscle layer of the injector, adjust the depth of the needle to avoid previous hard knots.
(2) Avoid repeated use of the same pen syringe. The repeated use of the needle will deform or blunt the subcutaneous tissue micro-trauma, increase local pain and infection, stimulate the traumatised tissue to release growth factors, growth factors and insulin meet, prompting the formation of hard knots in the subcutaneous fat, which is not conducive to future injections and also affects the normal absorption of insulin.
(3) Keep the skin intact and clean, avoid trauma, don't scratch the skin surface, don't wear tight clothes, try to wear cotton underwear without stimulation, change and wash often, keep clean and comfortable. Wash the injection site with lukewarm water every day before going to bed, don't scrub it with force, rub it gently so as not to damage the skin. Massage the local area 1~2 times a day, 10~15min each time, to promote local blood circulation.
3. Psychological care: Due to the lack of understanding of diabetes, patients are either too nervous (at the early stage) or not concerned (before complications occur) during the treatment process, resulting in poor compliance with the treatment, and they think that it is troublesome to take injections before every meal and to monitor blood glucose on a regular basis. Through psychological guidance, patients should be made aware of the role of insulin injection in controlling the disease. The correct injection method can reduce many complications, reduce the financial burden of the family and improve the quality of life. This is a test of perseverance, and should be accomplished through careful persistence. Encourage patients to exercise properly, listen to soothing and happy music, read books according to their own interests, learn more about the natural process of the disease, complication prevention, treatment of related knowledge on the compliance of injection on demand and have a correct understanding of the treatment will be proactive and effective.
4. Blood glucose monitoring: monitor continuously before and 2h after three meals and before bedtime at the beginning of the injection period until the insulin dosage is adjusted to control the blood glucose close to normal. Afterwards, monitor 1~2d per week, and continuously monitor if the blood sugar is unstable.
5. Identification and prevention of hypoglycaemic reaction: hypoglycaemia is the most common adverse reaction in insulin treatment, and repeated severe hypoglycaemic reaction can lead to brain dysfunction. Therefore, we must guide patients to accurately identify the typical symptoms of hypoglycemic reaction and preventive measures, mild to moderate hypoglycemic symptoms such as sweating, dizziness, palpitation, trembling, hunger, fatigue, headache, drowsiness, blurred vision and so on. Severe hypoglycaemia symptoms: disorientation, loss of consciousness, epilepsy and even death. Discuss with the patients about the relationship between the occurrence of hypoglycemic reaction and irregular medication, not eating in time or eating too little, too much exercise, and instruct the patients to eat regularly, exercise regularly and regulate the insulin treatment. After insulin injection, patients should eat in time and avoid going out before eating to prevent hypoglycemia, and carry candies, biscuits and diabetic first aid cards with them when going out to ensure that they can be treated in time in case of accidents, and tell patients that they can drink sugary drinks, eat candies and biscuits in case of mild to moderate hypoglycemia, and that it is better to be admitted to the hospital when severe hypoglycemia occurs.
6. Discharge guidance: Teach patients and their families the injection method during hospitalisation. Master the injection site and time, rotation method, local observation, blood glucose monitoring, and make records. Diet control, hypoglycaemia treatment. Adhere to exercise, which is helpful to control the condition. Instruct the family to supervise the patient not to eat snacks, not to drink alcohol, and to restrain the patient who is not strong in self-control, which can reduce the number of hospitalisation and control the condition.
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