Diabetes Specification Entry Day: You must tell patients these insulin injection knowledge
What is the sequence of insulin injection?
Taking insulin pen injection as an example, diabetic patients should check the injection part before injection of insulin, then disinfect the skin, and then inject in the following order: (1) pinch the skin. (2) Slowly injection of insulin with a 90 -degree angle with the skin surface. (3) After the thumb button is completely pushed down, let the needle stay in the skin for 10 seconds. (4) Pull out the needle from the same angle when piercing the skin. (5) Remove the skin. (6) The needle used for safety treatment.
Note: 1. The correct method of pinching the skin is to pinch the skin with the thumb and index finger (or the middle finger), and you cannot use multiple fingers to pinch the skin, which may pose the muscle layer.
2. In addition to pinching skin, for a longer needle (≥6mm) injection, the tilt angle (45 degree angle) can be used to ensure that insulin is injected into the subcutaneous tissue and reduces the risk of injection to muscle.
3. Stay for 10 seconds. This step cannot be less. Some patients may experience the leakage of insulin in injection. This is likely to be because the injection is not enough or unloaded in time after the injection is completed. In addition to the large waste of drugs, leakage will also cause liquid blocking needles, causing inaccurate injection doses to be inaccurate. At the same time, for premixing agents, leakage may cause a mixed proportion of insulin to change. Therefore, after the injection is completed, it is necessary to leave the needle for more than 10 seconds under the skin and remove the needle in time.
How to choose the injection part?
Insulin injection can be performed below, that is, the abdomen (about 1cm above the pubic bone, about 1cm below the minimum rib, bilateral abdomen other than 2.5cm other than the umbilical period) The outer side (1/3 on the front and outer side of the bilateral thigh), the hip (the outer side of the bilateral hip).
Selecting subcutaneous fat and no nerve distribution parts can reduce injection pain. The insulin absorption rate of different injection sites is slow and slow, and the abdomen is the fastest, followed by the upper arm, thighs and hips in turn. Therefore, it is best to choose abdominal injection in short -acting insulin during meals; if you want to slow the absorption speed of insulin, you can choose your hips, which can also minimize the risk of injection to muscle; injection to children patients patient When medium or long -acting insulin, it is best to choose the hip or thigh injection. However, the abdominal injection is generally the most. On the one hand, the absorption rate is the highest, up to 100%, fast absorption, and is not affected by the movement of the limbs. In addition, the subcutaneous tissue of the abdomen is thick, which can reduce the risk of injection to the muscle layer.
How to rotate insulin injection?
Insulin itself is a kind of growth factor, so repeated injection in the same part will cause the subcutaneous fat layer of the subcutaneous fat layer to generate hardships, or cause fat hyperplasia, causing the insulin absorption rate to Skin rotation.
You can take large rotation (abdomen-thigh-upper arm-hip rotation) and small rotation (divide the abdomen injection parts into 4 areas, thighs or hips, etc. Rotate clockwise). Note that in any part of the injection, each injection point should be at least 1 cm interval to avoid repeated damage of the tissue.
How to solve the problem of pain in insulin injection?
First of all, injection of pain may be related to psychological factors on the one hand. Medical staff needs to first provide psychological education for patients to reduce their terror in drug injection to help relieve pain.
Secondly, insulin injection is generally mild pain. If the patient feels obviously uncomfortable during the insulin injection process, you can consider the reasons for these aspects: (1) the length of the needle (and the penetrated tissue layer). The more obvious. (2) The diameter of the needle, the larger the diameter of the needle, the more obvious the pain may be.
In addition, the reused needle is also one of the causes of injection pain. Repeated needle can cause coating damage, which increases the pain of injection. Not only pain, but also the scratching coating gaps will grow bacteria, which can easily cause infection. In addition, the needle damaged needle is easy to break, causing tissue minimally trauma. Pain in injection will also increase the incidence of subcutaneous fat.
Response: (1) The insulin that is preserved in room temperature is preserved. If the insulin taken from the refrigerator, the insulin needs to be returned to the normal temperature state before injection. The “China Diabetes Drug Injection Technology Guide (2016)” recommends that the bottle insulin or insulin pen core that has been opened can be stored at room temperature (the preservation period is within one month after the opening, and it cannot exceed the shelf life). It is not recommended to keep preservation of insulin in use. This is because insulin products have better stability and easier mixing at room temperature. It also makes insulin injection more comfortable. Repeated temperature changes will affect the effectiveness of insulin. (2) If the injection site is disinfected with alcohol, it should be injected after the alcohol is completely volatilized; avoid injection at the root of the body hair (there is often abundant nerve ending near the root of the body hair). (3) Try to use shorter needles (4mm or minimum length), smaller diameter, and minimum penetrating needle can minimize pain. Each injection uses a new needle of sterile, do not reuse the needle. (4) Reasonably select the type of needle tube. Compared with the cone -shaped needle tube design, the column -shaped needle tube design can significantly reduce the damage to the skin tissue of the puncture operation. (5) Master the correct puncture method. The needle is too slow or too hard to walk in the skin. If the pain continues, the doctor needs to find the cause further. What if subcutaneous fat hyperplasia occurs?
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Without regulating rotation injection sites, skin fat hyperplasia will be caused. Some patients with long diseases may find that when insulin injection in the fat hyperplasia can reduce pain, however The comfort, so we must do a good job of patient education.
If subcutaneous fat hyperplasia has appeared, it should be switched to other injection sites. If diabetic patients do not discover subcutaneous fat hyperplasia in time, if the insulin is injected in the subcutaneous fat hyperplasia, if this problem is discovered, they should tell them that they need to stop injecting injects in the fat hyperplasia. At the same time When tissue normally, you may need to adjust the dose, otherwise it is easy to cause hypoglycemia. Generally, the hyperplasia site will fade after stopping insulin injection without special treatment.
