About Integrated Diabetes Services
Integrated Diabetes Services provides one-on-one education and glucose regulation for people who use insulin. Diabetes coaching services are available in-person and remotely via phone and the Internet for children and adults. Integrated Diabetes Services offers specialized services for insulin pump and continuous glucose monitor users, athletes, pregnancy & Type 1 diabetes, and those with Type 2 diabetes who require insulin. For more information, call , go to integrateddiabetes.com or write to .
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Too Much Insulin Or Not Enough
High morning blood sugar levels before breakfast can be a puzzle. If you haven’t eaten, why did your blood sugar level go up? There are two common reasons for high before-breakfast blood sugar levels. One relates to hormones that are released in the early part of sleep . The other is from taking too little insulin in the evening. To see which one is the cause, set your alarm to self-monitor around 2 or 3 a.m. for several nights and discuss the results with your health care provider.
Can I Mix Rapid
You can mix a rapid-acting insulin with an intermediate-acting insulin, according to your doctors instructions. Rapid-acting insulin should always be drawn into the syringe first. This will keep the intermediate-acting insulin from getting into the rapid-acting insulin bottle. After mixing rapid-acting insulin in the same syringe with an intermediate-acting insulin, you must inject the mixture under your skin within 15 minutes. Remember to eat within 15 minutes after the injection.
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Fear Of Insulin Injection: Putting It All Together
- Step One: Choose the lowest fear on your fear ladder.
- Step Two: Begin to do slow, deep breathing exercises.
- Step Three: Perform the lowest-feared step on your list. For example, watch an online video of someone injecting insulin.
- Step Four: Continue to sit with the lowest fear on your list, until the fear rises, peaks and then fades again. Stay with imagining or watching it until the fear fades. It may rise and fall a few times.
- Step Five: Once your anxiety has eased on the lowest fear and you have conquered this step, move on to the next-highest fear on your list.
When Do I Take Rapid
You should inject rapid-acting insulin no more than 15 minutes before you eat. Your doctor will tell you how much insulin to inject. Remember, you should not wait more than 15 minutes to eat after you take this insulin shot.
Rapid-acting insulin can be more convenient to take than regular insulin. With regular insulin, you inject the insulin and then wait 30 to 60 minutes before eating. Many people find it hard to time their meals around regular insulin injections. Sometimes they end up eating too soon or too late. Then they dont achieve the best blood sugar control. Since rapid-acting insulin is taken so close to mealtime, it may help you control your blood sugar more effectively.
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Why Do I Need To Take Insulin
All people who have type 1 diabetes and some people who have type 2 diabetes need to take insulin to help control their blood sugar levels. The goal of taking insulin is to keep your blood sugar level in a normal range as much as possible. Keeping blood sugar in check helps you stay healthy. Insulin cant be taken by mouth. It is usually taken by injection . It can also be taken using an insulin pen or an insulin pump.
How Do I Use An Insulin Pen
Select a clean, dry work area. The supplies you will need include:
- The prescribed insulin pen
- Pen needles and alcohol wipes
- A container for used equipment. You can use a hard plastic container with a screw-on or tight lid, or a commercial sharps container.
Here are the steps you will take:
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Give The Insulin Dose
Figure 10. Holding the insulin pen
How To Store Your Insulin Pens
Too much heat, cold, or sunlight can damage the insulin in your pens. Follow the instructions below to store your insulin pens.
- Keep your new, unused insulin pens in the refrigerator door. This keeps them from being pushed to the back of the refrigerator, where they can freeze.
- Keep the insulin pen youre currently using at room temperature . Once you use an insulin pen the first time, never put it back in the refrigerator.
- Never freeze your insulin pens.
- When youre going out in hot weather, dont let your insulin pen get too hot. Carry it in an insulated bag, or something similar, to keep it cool.
- If youre going to be out for a few hours, put a cold bottle of water in the insulated bag with your insulin pen. This will keep it from getting too hot for several hours.
- If youre going to be out for a longer time, you can put an ice pack in the insulated bag with your insulin pen. Wrap the ice pack or insulin pen in a towel to keep them from touching. If the pen touches the ice pack directly, the insulin can freeze.
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Prepare The Insulin And Syringe
- Remove the plastic cap from the insulin bottle.
- Roll the bottle of insulin between your hands two to three times to mix the insulin. Do not shake the bottle, as air bubbles can form and affect the amount of insulin withdrawn.
- Wipe off the rubber part on the top of the insulin bottle with an alcohol pad or cotton ball dampened with alcohol.
- Set the insulin bottle nearby on a flat surface.
- Remove the cap from the needle.
If you’ve been prescribed two types of insulin to be taken at once , skip to the instructions in the next section.
- Draw the required number of units of air into the syringe by pulling the plunger back. You need to draw the same amount of air into the syringe as insulin you need to inject. Always measure from the top of the plunger.
- Insert the needle into the rubber stopper of the insulin bottle. Push the plunger down to inject air into the bottle . Leave the needle in the bottle.
- Turn the bottle and syringe upside-down. Be sure the insulin covers the needle.
- Pull back on the plunger to the required number of units .
- Check the syringe for air bubbles. Air bubbles in the syringe will not harm you if they are injected, but they can reduce the amount of insulin in the syringe. To remove air bubbles, tap the syringe so the air bubbles rise to the top and push up on the plunger to remove the air bubbles. Recheck the dose and add more insulin to the syringe if necessary.
- Remove the needle from the insulin bottle. Carefully replace the cap on the needle.
Important Tips To Remember About Using An Insulin Pen:
- Always check your medicine type and the expiration date printed on the box before you leave the pharmacy.
- Store unopened pens in the refrigerator. They will be good until the expiration date printed on the box. Write the date on the insulin pen when you first open it.
- Store open insulin pens at room temperature. Avoid temperatures that are too hot or too cold. This can change how the insulin works.
- Most pens are good for 28 days once opened. Check with your pharmacist or read the drug insert for exact instructions.
- Do not use insulin pens that have lumps, are discolored or have been frozen.
- Place used pen needles and lancets for blood sugar testing in a hard plastic or metal container with a screw-on or tight lid, or a commercial sharps container.
- If you have questions about the subcutaneous injection procedure, please ask your healthcare providers.
- The most common side effect of insulin is low blood sugar, or hypoglycemia. Low blood sugar happens when the level of sugar in the blood falls below 70 mg/dl. Symptoms include sleepiness, shaking, sweating, dizziness and hunger. Be sure you know how to treat low blood sugar before you start using insulin.
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Insulin Injection Technique: Tips And Tricks
Self-injection can be harder than it sounds. People may experience bruising or scarring at injection sites, give themselves incorrect doses, or inject in ways that lead to poor uptake of insulin in the body. They may find the process scary and uncomfortable. Here are some common mistakes that make it harder and some ways to make it easier.
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How Can I Keep My Blood Sugar Level From Getting Too High Or Too Low
You need to check your blood sugar level regularly using a blood glucose monitor. Your doctor or his or her office staff can teach you how to use the monitor. Youll need to write down each measurement and show this record to your doctor. He or she will use this information to decide how much insulin is right for you.
Blood sugar measurements can vary depending on your lifestyle. Stress levels, how often you exercise, and how fast your body absorbs food can affect measurements. Hormonal changes related to puberty, menstrual cycles, and pregnancy can, too. Illness, traveling, or a change in your routine may mean that you have to monitor your blood sugar level more often.
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Overcoming Fear Of Injections
Injections may be hard for both you and your child. But there are things you can do to make it easier. To calm your childs fears:
- Treat injections as normal and routine.
- Ask about giving yourself a test injection with saline. That way you will know how an injection feels.
- Praise your child for not delaying or making excuses. If your child needs to complain, give him or her time for that after the injection is over.
- If your child is afraid of needles, ask his or her healthcare provider, nurse, or diabetes educator for help. For example, ask about devices that blocks your child’s view of needles.
When Should I Take Insulin
You and your doctor should discuss when and how you will take your insulin. Each persons treatment is different. Some people who use regular insulin take it 30 to 60 minutes before a meal. Some people who use rapid-acting insulin take it just before they eat.
Types of insulin:
- Rapid-acting insulin starts working in about 15 minutes. It lasts for 3 to 5 hours.
- Short-acting insulin starts working in 30 to 60 minutes and lasts 5 to 8 hours.
- Intermediate-acting insulin starts working in 1 to 3 hours and lasts 12 to 16 hours.
- Long-acting insulin starts working in about 1 hour and lasts 20 to 26 hours.
- Premixed insulin is a combination of 2 types of insulin .
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Insulin Injection Technique: Learn And Practice
As with learning anything new, the keys to insulin injection success are training and practice. Ask your doctor or educator to show you how its done, and to guide you through doing it yourself. There are also training devices you can take home to practice with. Studies show that people who practice injecting are much more likely to do it right and to keep doing it.
Take the doctors informational handouts, and also watch videos of insulin injections. You can find videos on YouTube for injecting with an insulin pen and with a syringe. You can do this.
When To Give An Insulin Injection
- If youre using rapid-acting insulin, inject it within 15 minutes before your meal. Its best to inject it just before you start eating. This helps prevent low blood sugar.
- Most mealtime insulins work for 4 hours. Dont inject mealtime insulin more often than every 4 hours unless your healthcare provider tells you to. For example, if you eat breakfast at 8:00 am, dont inject your next dose of mealtime insulin until 12:00 pm or later. Injecting doses too close together can cause low blood sugar, which can be dangerous.
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How To Inject Insulin
Before injecting insulin, be sure to check its quality. If it was refrigerated, allow your insulin to come to room temperature. If the insulin is cloudy, mix the contents by rolling the vial between your hands for a few seconds. Be careful not to shake the vial. Short-acting insulin that isnt mixed with other insulin shouldnt be cloudy. Dont use insulin that is grainy, thickened, or discolored.
Follow these steps for safe and proper injection:
When Is The Best Time To Inject Insulin
The best time to inject insulin depends on the type of insulin you have been prescribed. Each persons treatment is different. Some people who use rapid-acting insulin take it just before they eat. Some people who use regular insulin take it 30 to 60 minutes before a meal.
There are 4 main types of insulin:
- Rapid-acting insulin starts working in about 15 minutes. It lasts for 3 to 5 hours
- Short-acting insulin starts working in 30 to 60 minutes and lasts 5 to 8 hours
- Intermediate-acting insulin starts working in 1 to 3 hours and lasts 12 to 16 hours
- Long-acting insulin starts working in about 1 hour and lasts 20 to 26 hours
- Premixed insulin is a combination of 2 types of insulin .
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Where Do I Inject The Insulin
Insulin is injected just under the skin. Your doctor or his or her office staff will show you how and where to give an insulin injection. The usual places to inject insulin are the upper arm, the front and side parts of the thighs, and the abdomen. Dont inject insulin closer than 2 inches from your belly button.
To keep your skin from thickening, try not to inject the insulin in the same place over and over. Instead, rotate injection places.
When To Throw Away Your Insulin Pens
Youll use the same insulin pen over and over for a certain number of days. The number of days depends on the type of insulin pen youre using. The table below lists some common types of insulin pens and the number of days you can use each one. You can also read the instructions that come with your insulin pens.
Whenever you start using a new insulin pen:
For example, if you start using a Lantus SoloStar insulin pen on January 1st, count ahead 28 days to January 28th. Write January 28 on a piece of paper tape and put the paper tape on the pen. Throw away the pen on January 28th, even if theres still insulin in it.
You can keep unused insulin pens in the refrigerator until the expiration date listed on the pen label. Once an insulin pen reaches the expiration date listed on the pen label, throw it away.
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