The confirmation of the patient's diabetes becomes at times a shocking picture: the patient immediately begins to think about what foods he can not eat now, how many times to limit physical exertion, what will happen to the level of sugar and how to prick insulin. The answers to these questions depend directly on the type of disease and its duration.
Scheme selection
First of all, it is necessary to determine the scheme of introduction. This is the task of the endocrinologist. It should be noted that this scheme is not standard for everyone. The regularity and dose of insulin injection is determined by the result of weekly self-monitoring of blood sugar level. If the endocrinologist does not pay attention to these data, appointing two injections a day, it is necessary to change the specialist. A good doctor will calculate the exact dose, tell you how to properly inject insulin and how many times a day. Incorrectly designed scheme can lead to deterioration of health!
First of all, the doctor finds out the need for prolonged insulin on an empty stomach. Then it is determined whether there is a need for fast insulin pricks before meals and how much it needs. Sometimes the first and second variant of insulin injection is necessary. To do this, the doctor studies the blood sugar level for the last seven days in the morning, in the evening, before and after eating, given the attendant circumstances. These include the diet of the patient, how many times and how tightly it feeds, physical activity, infectious diseases, the dosage of drugs from diabetes, in addition, the products consumed every day.
An important indicator is the level of sugar before going to bed and after waking up. It depends on the dose of insulin injection at night.
First type of disease
Type 1 diabetics need fast insulin pricks before meals or after meals. In addition, an injection of prolonged insulin is given before bedtime and in the morning to maintain a normal level of sugar in the blood on an empty stomach. The combination of prolonged insulin in the evening and in the morning, as well as fast insulin before meals, allows you to simulate the activity of the pancreas in a healthy body.
- Extended insulin - for injections at bedtime and on an empty stomach to maintain a daily norm in the blood.
- Fast insulin - before eating, to avoid jumps after eating.
In addition, diabetics of the first type show a low-carbohydrate diet and low physical activity. Otherwise, jumps of the sugar index in the blood can not be avoided, and fast insulin therapy before meals will be ineffective.
The second type of disease
The main cause of this type of disease is a decrease in sensitivity to insulin or insulin resistance. In this case, the production of insulin, sometimes even in excess. The vast majority of patients with type 2 diabetes successfully maintain blood sugar through a low-carb diet, bypassing the minimum concentrations of the prick before meals.
In case the patient feels an ailment associated with infectious diseases, it is necessary to perform injections every day, otherwise, as a result of relapse, the disease can pass into a variety of the first type.
Often, pills replace rapid injections of insulin. But after taking pills that increase sensitivity to insulin, you need to wait at least an hour before embarking on a meal. In this plan, the injections are more practical - after the injection you can eat after half an hour, and wait more often on the working day for patients most often does not work.
Tips before prescribing injections
Calculate how much insulin is needed for each injection, not difficult. But it is advisable only for those who follow the diet. Otherwise, jumps of sugar will be observed regardless of the dose.
The calculation assumes that the patient makes an injection before and after sleep, thereby maintaining the daily level, which means that it rises only after eating. The measurement of blood sugar concentration should be performed several times a day, and the glucometer should be absolutely accurate.
If the patient adheres to a prescribed diet, then after a meal, doctors recommend injecting a short insulin. There is also an ultra-short, but it is only suitable for instant repayment of sudden jumps of sugar and for the normal assimilation of food will be less useful.
The correct preparation of
In the house of a patient with diabetes should be kitchen weights. This will serve as a help for those who want to monitor how many carbohydrates in food. Sugar concentrations in the blood should be measured up to ten times a day for a week. Recording the results for each day will help to clearly determine before what food intake an injection is needed, and how many units of insulin are needed.
Shelf life and storage conditions must be strictly adhered to. Overdue insulin may or may not act, or act completely unpredictably. In addition, overdue drugs have different pharmacodynamics, which can not be traced clearly, especially when it comes to hormones. Do not use overdue insulin.
Do not be afraid of injections. When it is determined how much and where to inject insulin, it is very easy to learn the correct technique of administration. And for patients on the right diet, they will also need knowledge on diluting insulin.
Patients should have glucose in their pills on hand in case of possible over dosage. The difference between the dose of a person who adheres to a diet and not is a colossal one.
Syringe selection
Insulin syringes are for single use only. They are made of plastic, have a thin short needle. However, there are also significant differences in their varieties.
The most important thing in the syringe is the scale. It determines the accuracy of administration and dosage. Calculate the step scale is very simple. If between zero and ten there are five divisions, then the step is two units of insulin. With such a syringe it is difficult to work if a dose of one unit is needed.
In addition, there is also the error in calculating the dose and its introduction - this error is half the calculated step, that is, in the example given - this is one unit of insulin! It follows that the line between the desired level of sugar and hypoglycemia is very thin. The most important skill is working out the introduction of an exact dose. To do this, you can use syringes with a more accurate step. The smaller the step, the more accurate the dosage. It is also recommended to master the technique of diluting insulin.
One injection should be no more than eight units of insulin. The concentration for which the syringe is calculated is indicated on the package with the letter U.
Based on the foregoing, ideally the syringe should be no more than ten units in length, and the dividing line should not exceed a quarter of units. Moreover, the divisions must be at each other at a distance sufficient for an error-free introduction. It turns out that the syringe must be very thin and long. But, unfortunately, such on sale yet. A common standard is syringes with a step size of two units.
The choice of needles and the technique of their introduction
The introduction of the medicine is made in a layer of subcutaneous fat. Since immediately followed by muscle tissue, it is very important not to get into it, do not inject too deeply, or make it superficial, in the skin. A common mistake is the introduction of the needle at a certain angle, when insulin enters the muscle tissue.
Short insulin needles - ideal for those who are afraid of getting into the muscle. Their length is from 4 to 8 mm, they are slightly thinner than standard needles and have a smaller diameter. They are used in the technique of painless administration. Such needles are best suited for adult patients.
In those skin areas where the fat layer is minimal, it is necessary to form a crease, while it is very important not to make it too compressed to not get into the muscle. Such areas of the skin are on the hands, feet, and if the prick is put in a tight stomach.
If an adult patient uses needles more than 8 mm, it is necessary to form a fold from the skin and insert the needle at an angle of 45 degrees. Otherwise, the injection will pass into the muscle. It is better not to use this needle if your stomach is pricked.
It is recommended not to use one needle in cases where it has already been applied. Subsequent injections will become more and more painful because the tip of the needle begins to become dull. In addition, this leads to complications in the form of bruises, seals and microscopic tissue ruptures.
Using a syringe pen, many ignore the manufacturer's recommendation, which states that the needle should be removed after each injection. Otherwise, air bubbles enter the vial of the syringe-pen, which complicates the administration of the drug and its concentration from the planned drops to almost half.
Syringe Pens This is a special type of syringe, in which a small cartridge of medicine is provided. Their only drawback is that they still have a scale with a dimension of one unit. Thus, the exact injection of a dose of up to 0.5 U with a syringe pen is still difficult. It is not recommended to use them if the doses are low enough. Also, pay attention to the cartridge, so as not to buy overdue insulin.
Painless injection
Even if the injections are canceled and the doctor prescribed the medication in tablets, the ability to put the shot correctly should be developed. This is necessary in case the patient becomes infected with an infectious disease, or caries or any other inflammatory process is found. In this case, the sensitivity of cells to insulin is sharply reduced and injection with injection is necessary.
Places where you can put the injections, differ in the amount of fatty layer. The fastest absorption of the drug occurs if you inject in places such as the stomach or shoulder. Most often, doctors recommend it is the stomach. Less effectively - in the area above the knee and over the buttocks.
Skin skin for prick in the stomach should be done with the index finger and thumb, while not strongly squeezing. In order for the process to pass without painful sensations, it must be carried out very quickly. The technique of introduction is to make a prick similar to throwing a dart in a darts game, so that it passes quickly.
Touching the needle against the skin and then squeezing it is a popular mistake that will cause trouble both in terms of sensations and in terms of skin problems at the injection site, especially if it is a stomach where the skin is sensitive enough. If she became painful, choose other places.
You can start the dispensing of the syringe 5-8 cm before the place, so that the dialed speed is sufficient for the rapid introduction of the needle. When the needle is under the skin, you can begin to move the plunger of the syringe quickly, so that insulin will pass painlessly. When the fluid is over, do not remove the needle immediately. You need to wait 5 seconds, after which you can remove the syringe from the injection site with a quick movement.
The dose should be in this position of the syringe when it is under the vial that will be put on the needle. It is strictly forbidden to inject a mixed type of insulin!
If necessary, dilute insulin, do it best with saline from the pharmacy or water for injection. Dilution can be carried out immediately in a syringe, resulting in a ready-to-inject solution.
When it is necessary to achieve a tenfold dilution, it is necessary to take one part of the preparation for 9 parts of saline or water for injection.
