Recommendations for the application of insulin: insulin pens and syringes
Proper insulin administration technique is critical for optimal diabetes control.
The 4mm needles are long enough to pierce the skin and reach the subcutaneous adipose tissue (SAT), with little risk of intramuscular (IM) injection. Therefore, they are considered the safest pen needles for adults and children regardless of age, gender, ethnicity or BMI.
In obese people, the 4mm needle is also the first choice, but a 5mm needle is acceptable. The 4 mm needle should be inserted perpendicular to the skin (90 ° angle to the skin surface), with or without a fold.
Very young children (less than 6 years old) and very thin adults should use 4 mm needles by folding and inserting the needle perpendicularly. The others can be injected with the 4mm needle without making a fold.
The safest syringe needle available for all patients is 6mm in length. However, when using a syringe needle in children (over 6 years old), adolescents, or thin to normal adults (BMI 19-25), injections should always be given in a fold.
Children using a 5mm pen needle should always inject themselves by folding or swapping for 4mm needles. Injecting at a 45 ° angle using a 6mm needle is an acceptable substitute for making a fold. If the arms are used for injections with needles of 6 mm or more, a fold must be made and this requires the injection to be given by another person.
Avoid pushing the needle cone so deep that it marks the skin as this increases the risk of IM injections. Patients with tremors or other conditions that make it impossible to hold a 4mm needle in place may need longer needles.
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Correct fold for insulin application
A correct fold is made by lifting the skin with the thumb and index finger (possibly adding the middle finger).
The fold should be done smoothly, not squeezing so hard that it may cause bleaching or pain.
The sequence when injected into a fold is as follows:
1) Gently lift a fold;
2) inject the insulin at a 90 ° angle to the surface of the fold;
3) after pressing the injection button (when using a pen), let the needle remain in the skin for a count of 10;
4) withdraw the needle from the skin at the same angle that it was inserted;
5) release the fold; Y
6) Safely dispose of the needle.
There is an association between needle reuse and LH.
There is also an association between needle reuse and pain or bleeding when injecting.
Needles (pens and syringes) should be used only once as they are no longer sterile after one use.
Many people who use insulin find it a nuisance to carry extra needles when they are away from home. Sometimes they have to pay part or all of the cost for their needles and some people decide that it is not worth buying a new needle for each injection. It also happens that they find reused needle injections not noticeably more painful, as long as they are not overused. But reusing needles is not a good practice.
Safe disposal of needles
Needles should always be disposed of covered and safely to avoid injury to others and should not be disposed of directly in household or public trash.
Proper use of insulin pens: The pen must be flushed prior to insulin delivery to ensure free and unobstructed flow: dial 2 units on the dose selector and press the injection button; At least one drop of insulin should be visible at the tip of the needle. Once the flow is verified, the desired dose can be marked and the insulin injected.
The pens and their cartridges are for one person use only and should never be shared with another. After use, the needles should not be left in the pen and should be discarded immediately. Otherwise, air or other contaminants can get into the cartridge or insulin can leak, which can distort the accuracy of the dose.
Pen needles should only be used once. They are no longer sterile after use.
The injection button should not be touched until the needle has been inserted into the skin and then it should always be pressed vertically (along the axis of the pen), not at an angle.
After you have fully depressed the button, you should slowly count to 10 and then remove the needle from your skin. This is necessary to avoid insulin leakage and to obtain the full dose.
Some people may need to count to more than 10, especially when applying higher doses.
Pressure should be maintained on the button until the needle is completely withdrawn from the body.
To be sure of using them properly, the instruction manual for the specific pen being used should be consulted.
Proper use of syringes
People who use syringes must ensure that the syringe is suitable for the insulin concentration they use. Each syringe has appropriate scale markings for a single insulin concentration, and mismatch of syringes with insulin can result in a severe overdose or underdose.
Fixed needle syringes provide better dose precision and allow mixing of insulins if necessary.
To draw insulin from the vial, air must first be drawn into the syringe at a dose equal to or slightly higher than the insulin dose to be administered. Air is then injected into the vial to facilitate the withdrawal of insulin.
If air bubbles are observed in the syringe, the barrel of the syringe should be tapped slightly to bring them to the surface and then removed by pushing the plunger up.
Unlike pens, when using syringes, it is not necessary to leave the needle under the skin and count to 10 after the plunger is fully depressed.
Syringe needles should be used only once. They are no longer sterile after use.
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