Preservation of insulin
1. Unopened insulin should be stored in the refrigerator at 2~8 °C, not near the inner wall of the refrigerator.
2. The opening time should be indicated when insulin is turned on. Once the insulin is opened, do not put it back in the refrigerator. It should be placed in a cool place at room temperature (not exceeding 25 ° C) and used within the specified time. Insulin in use should be used up within 4 weeks. If it is bottled insulin, it can be stored in the refrigerator for long-term storage. Do not put the insulin in the insulin pen back into the refrigerator, so as not to affect the life and accuracy of the pen.
3. Insulin is neither cold nor hot, so it cannot be placed next to window sills, cars, heating, computers, etc. When traveling and flying, you should carry the insulin with you, and you can keep it with a thermostat if conditions permit. Do not pin your insulin in your baggage to prevent deterioration due to excessive temperature and excessive shock.
4. Installed insulin injection refills should not be stored in the refrigerator. Do not store with a needle, otherwise it may cause leakage or air bubbles, and the injection volume accuracy is not enough.
5. Check the expiration date before each use of insulin, and observe whether the liquid is abnormal, such as crystals, floes, etc. Once found, stop using it immediately. Do not use the insulin that has expired or has not been used up for the storage period. Bottled insulin, refill insulin, and special pen can be stored for 2 and a half years at 2~8°C. Bottled insulin can be stored for 6 weeks at room temperature of 25°C, refilled insulin for 4 weeks, and special pen can be stored for 6 weeks.
Use of insulin
Wash hands before injecting insulin, take it out of the refrigerator, leave it at room temperature for a while, and then use it until the temperature returns to room temperature. Also pay attention to these points when using insulin:
6. When using medium-effect, suspended insulin, use each hand to shake the insulin pen back and forth 10 times before each injection, and then upside down 10 times, when it is even white, it can be used. There is a small bubble in the insulin refill that has the needle inserted. You need to flick the pen to let the small bubble float to the top. Then, like injecting insulin, adjust the two units and push the injection button up. If the bubbles are not exhausted, Repeat the above steps until the insulin drop appears on the tip of the needle, indicating that the venting was successful. If the bubble can be discharged before each injection, the needle is smooth.
7. The injection should be carried out under the skin to avoid getting into the muscle layer. Otherwise, the insulin absorption curve will not be consistent with the blood glucose absorption peak, and the blood sugar fluctuation will be large. When injecting, use your thumb and forefinger or middle finger to pinch the skin, then inject it, make sure to inject into the subcutaneous layer, avoid holding the skin with full fingers, prevent mis-squeezing the muscle layer, and make the injection into the muscle. The needle angle is 45° (child and lean adult) or 90° (normal weight and obese adults). When injecting insulin into the abdomen, it is necessary to pinch the skin and avoid the around the navel. After injecting insulin, wait for the needle to stay in the skin for about 10 seconds, then pull out the needle and loosen the skin folds.
8. Insulin injection is slower, and the needle is removed in time after injection. Disinfect the skin with alcohol when injecting, and then inject after drying. Avoid wiping the needle with a sterile cotton swab before injection.
9. When injecting insulin with insulin pen, check whether the refill is damaged or cracked, whether there is any defect in the head of the putter, whether the insulin drug has been used up, and clean the pen in time. If the putter part is missing, you need to find a new insulin pen in time, and replace the new refill after the liquid is used up.
10. When selecting the injection site of the pancreas, you can use the method of alternating the abdomen, buttocks, arms and thighs. Otherwise, it will easily cause induration at the injection site and affect the absorption of insulin. It is best not to inject at the same injection site within one month. When using short-acting insulin, the abdomen is usually selected as the injection site, and when the intermediate-acting insulin is used, the outer portions of the buttocks and thighs are usually selected. When using premixed insulin, choose abdominal injection before breakfast, and in the evening to avoid hypoglycemia, usually choose thigh or buttocks as the injection site.
Adverse reactions to insulin
11. When insulin is used for the first time, edema may appear on the face or limbs. This is related to insulin promoting renal tubular reabsorption of sodium. It usually fades away within a few days (less than one month). Treatment: low-salt diet, severe edema may be oral diuretics (such as spironolactone).
12. During the use of insulin, local or systemic allergies may occur if the insulin is of low purity or contains added chemical ingredients such as protamine and zinc. Local allergies are only pruritus and itching around the injection site and around. Systemic allergies can cause urticaria, and in very few cases, anaphylactic shock can occur. Need to use different types of preparations or switch to insulin produced by different companies, often change the injection site, and apply anti-allergic drugs as appropriate.
13. After insulin treatment, blood sugar will drop rapidly, which may cause changes in the osmotic pressure of the lens and vitreous of the eye, and the outflow of water in the lens, which may cause blurred vision and decreased refractive power. But don’t be afraid, this kind of phenomenon is generally temporary, and most of them will recover after a few weeks. Most occur in patients with initial insulin use.
14. After insulin injection in diabetic patients, most people will experience different degrees of weight gain, which is unavoidable. Especially in elderly patients with diabetes, abdominal obesity often occurs after insulin injection. The patient can gradually reduce the amount of insulin (according to the doctor’s advice) after the blood sugar control is good, and with the scientific diet and reasonable exercise, reduce the incidence of obesity.
15. When using unpurified insulin, it may cause depression or depression of the injection site. Frequent replacement of the injection site or the use of high-purity insulin can significantly reduce the incidence of lipoatrophy.
16. If insulin is injected into the same area every day, the skin and subcutaneous tissue may become thicker and scarred, forming an “insulin lumps.” Patients who inject insulin at the same site multiple times a day occur more often, and are mostly located in the abdomen. Selecting a purified insulin product, rotating the injection site, and not using the needle repeatedly, can avoid fat hyperplasia at the injection site.
17. For diabetic patients, blood glucose levels ≤ 3.9mmol / l, is low blood sugar. In order to avoid the hypoglycemia reaction caused by the excessive use of insulin, it is necessary to start from a small dose, while closely monitoring the blood glucose, and gradually adjust to the appropriate dose. You should also carry foods such as candy, desserts, etc., in order to be able to self-rescue in the event of hypoglycemia.
I hope that everyone can learn the correct way of storing and using insulin to achieve the best therapeutic effect of insulin therapy, effectively control hyperglycemia, delay and avoid the occurrence of various chronic complications.