This is an automatically translated article.
When having to inject insulin, diabetics need to be equipped with some relevant knowledge to be able to make the most of the drug's effectiveness. Here are some things that patients need to discuss with their doctor before taking insulin.1. What types of insulin are there?
There are 4 basic forms of insulin including:
Immediate-acting insulin: Starts working within a few minutes of use and lasts only a few hours; Regular or short-acting insulin: It takes 30 - 60 minutes for full effect and the effects can last 3 - 6 hours; Moderate-acting insulin: It takes 2 - 4 hours for full effect and the effect lasts for 18 hours; Long-acting insulin: It takes 6 to 10 hours to reach maximum blood levels and can last all day. Depending on the patient's case, the doctor will advise on the appropriate form of insulin to ensure the best therapeutic effect.
2. Routes of insulin use
Insulin can be used by injection or inhalation.
Injection route
To inject insulin, you can use a needle, pen or syringe.
Intramuscular injection helps insulin to be absorbed and work faster. However, intramuscular injection is not a common route of administration because of its own risks. Intramuscular injection should not be given to areas with a thick layer of fat and for intramuscular injection, a longer needle should be used to allow the needle to reach the muscle. Thin people can use a regular subcutaneous needle for intramuscular injection.
The most rapidly absorbed insulin injection site is the abdomen (the injection site is at least 5cm away from the navel), followed by the arms, thighs and buttocks. The difference in absorption time is used to prolong or shorten the duration of insulin action. In addition, some people with lipohypertrophy have a slower absorption of insulin.
Inhalation
There is an inhaled insulin that has an immediate effect. However, this type of insulin can only be used before meals. For patients with type 1 diabetes, long-acting insulin is required.
Diabetics should talk with their doctor about the benefits of each method of insulin administration to get the best treatment option.
Bút tiêm dễ sử dụng nhất, bơm tiêm sẽ phân phối insulin liên tục còn kim tiêm có giá thành cao nhất
3. How to calculate insulin injection dose
Patients should ask their doctor about how many times a day to use insulin and the dose of each dose. If using an insulin pump, patients should ask their doctor when to use a booster dose (bolus dose). Typically, patients with type 1 diabetes will need insulin injections 3-4 times a day. Patients with type 2 diabetes need to inject 1 dose of insulin per day. However, there are cases where it can be injected 3-4 times a day depending on the doctor's prescription.
The rate of insulin absorption varies from person to person. For example, when injecting semi-slow insulin (NPH, lente), the drug works for 16 - 20 hours but in some people it is only 8 - 10 hours. Compared between different days, in the same person receiving the same insulin and the same insulin dose, the same location, the duration of action can also change by 50% and the time to reach the peak can also change. 25 - 50%.
With a small injection dose of 5 - 10 units, there is no difference in absorption. With higher doses, eg 20 units injected, insulin will be absorbed more slowly than with 10 units injection. The difference is most pronounced when injecting high doses of more than 100 units of insulin.
Some diabetics are able to self-adjust their daily insulin injections (increase or decrease) according to the amount of food eaten at each meal. Note: if not carefully instructed by the doctor, the patient should not arbitrarily adjust the dose of insulin injection to avoid the risk of hypoglycemia.
4. Time to inject insulin
The time to inject insulin depends on many factors such as:
The type of insulin the patient uses: Fast acting, long acting, mixed form,...; Amount and composition of food consumed by the patient; Frequency of movement of the patient; Other acquired diseases; Insulin injection tools: Needles, pens, syringes,... Injecting insulin before or after eating? Normally, patients should inject insulin before meals. The time between injection and eating varies depending on the type of insulin so that the drug is ready to take effect when the sugar from the food begins to enter the bloodstream. For example, with regular insulin is 20-30 minutes, mixed insulin is 30 minutes, semi-slow insulin is 60 minutes,... If you eat later after the appropriate injection time, the patient has a high risk of hypoglycemia. .
5. How to inject insulin?
Diabetics should ask their doctor about the correct injection method and the injection area to avoid infection. At the same time, the patient needs to learn how to rotate the injections so that the skin does not harden or deposit subcutaneous fat due to repeated injections.
Roll the insulin vial before injecting: Roll the vial or injection pen to warm and mix insulin well. Only rolling the vial of slow-release insulin or mixed insulin is recommended, and regular insulin is not required. The patient should not shake the insulin vial vigorously because air bubbles are easily created and when insulin is withdrawn into the syringe, air may enter the syringe; Inject insulin according to instructions on injection site, injection dose; After injecting insulin, there will be a part of insulin that is lost due to being broken down (destroyed) by enzymes present in the subcutaneous tissues. In the majority of patients, the amount of insulin degraded is very small, does not affect the overall effect and does not require an increase in dose. However, a small number of patients have very large insulin breakdown in the subcutaneous tissue, so to achieve the goal of glycemic control, they must inject insulin with very large doses, possibly up to over 200 units. This does not occur if insulin is injected intravenously. To overcome it, insulin can be injected with an enzyme inhibitor called trasylol, but this drug is quite expensive. Therefore, the simplest and most effective way is to inject more insulin; Exercising, massaging the muscles in the insulin injection area will increase insulin absorption. So, if you want to increase insulin absorption, you can do light exercise; Storing insulin: Uninjected insulin vials should be stored in the refrigerator. The insulin vials in use can be kept in the refrigerator or in a cool place. Insulin should not be left in the heat or in direct sunlight. Patients should also ask the doctor about how long the effects of insulin are, how insulin is damaged and cannot be used anymore,...; About reuse of needles: Patients should ask the doctor if it is safe to do so, how to keep the needles clean to prevent infection. And if you throw away the needle after use, how to safely dispose of it,...
Người bệnh cần học cách luân chuyển mũi tiêm để vùng da không bị cứng hay lắng đọng mỡ dưới da do mũi tiêm lặp lại
6. Is insulin injection harmful?
Common side effects: Low blood sugar and weight gain; Causes lipodystrophy at the injection site (atrophy or hypertrophy). If purified or human insulin is used, the risk of lipodystrophy at the injection site is very low, unless it is administered to children.
7. Some other problems
Drug interactions: Some drugs can increase the blood sugar-lowering effect of insulin, so patients need to discuss carefully with their doctor about the drugs they are taking; Diet: Diabetics should ask their doctor about the foods they should eat so that insulin can work at its best; Target blood sugar level: Patients must regularly check their blood sugar with a blood glucose meter. Patients should monitor blood sugar before, after eating and before going to bed. For most patients with diabetes, the goal of treatment is usually: 70 - 130 mg/dL before meals and less than 180 mg/dL 1 - 2 hours after starting a meal. If blood sugar is not within the limits, the patient should consult a doctor and ask when to check the A1c test. If patients have any questions about insulin use, they should write them down to ask their doctor at their next visit. During the visit, the doctor can check the progress of the disease, give advice to the patient to control his diabetes well.
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