• Insulin Injection Technique

    The insulin needs to go into the fat layer under the skin. Pinch the skin and put the needle in at a 45º angle. If your skin tissues are thicker, you may be able to inject straight up and down (90º angle). Check with your provider before doing this. Push the needle all the way into the skin.

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    Robert Roscoe, BSc. Pharm, ACRP, CDE, CPT, Pharmacist and Certified Diabetes Educator goes through the steps of proper injection technique when administering insulin.
    Robert Roscoe, BSc. Pharm, ACRP, CDE, CPT, Pharmacist and Certified Diabetes Educator goes through the steps of proper injection technique when administering insulin.
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    Lori Berard, RN, CDE, Diabetes Educator, goes through the steps of how to inject insulin safely and effectively.
    Lori Berard, RN, CDE, Diabetes Educator, goes through the steps of how to inject insulin safely and effectively.
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    Robert Roscoe, BSc. Pharm, ACRP, CDE, CPT, Pharmacist and Certified Diabetes Educator, talks about what lipohypertrophy is and how to avoid getting them when injecting insulin.
    Robert Roscoe, BSc. Pharm, ACRP, CDE, CPT, Pharmacist and Certified Diabetes Educator, talks about what lipohypertrophy is and how to avoid getting them when injecting insulin.
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    Lori Berard, RN, CDE, Diabetes Nurse Educator, goes over a variety of frequently asked questions when it comes to injecting insulin properly.
    Lori Berard, RN, CDE, Diabetes Nurse Educator, goes over a variety of frequently asked questions when it comes to injecting insulin properly.
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    Robert Roscoe, BSc. Pharm, ACRP, CDE, CPT, Pharmacist and Certified Diabetes Educator, talks about how to properly rotate insulin injection sites in order to avoid developing lipohypertrophy.
    Robert Roscoe, BSc. Pharm, ACRP, CDE, CPT, Pharmacist and Certified Diabetes Educator, talks about how to properly rotate insulin injection sites in order to avoid developing lipohypertrophy.
  • Injecting Insulin Properly - Frequently Asked Questions

    We’re often asked why the FIT recommendations include 4-, 5- and 6-millimetre needles when we know that the shorter the better. Well, we have to do that because people across the country don’t necessarily have access to 4-millimetre needles, so we really want them to be using the shortest needle possible.

    Then the other thing that comes up as a frequently asked question is if someone’s BMI is higher, does that mean they need the longer needle? And in fact, no. Research has shown that using a 4-millimetre needle in people with high BMI results in as good of glucose control as using a longer needle, so short is fine for all.

    We continue to learn more about insulin injections all the time, and recently we’re starting to understand what force does to the injection. So what does that mean? If you jam your insulin injection into your tissue, you in fact increase your risk of hitting muscle. You also then squish your fat or subcutaneous tissue, and that can affect the way that you are absorbing your insulin. So, our recommendation to you is instead of jamming in your insulin, you want to think about sliding it in, like sliding it into butter.

    One of the questions I’m asked very frequently is when should I split someone’s insulin dose? There’s evidence for the older human insulins that if you in fact split the insulin dose then you get a better time-action profile. The bigger the dose, the smaller the peak with human insulins.

    So, that’s why we split NPH regular insulins. But, with the newer basal insulin analogs, there’s no evidence that you need to split the dose. In fact, you only split the dose as a function of the device. So, if the dose is higher than the amount that the device will deliver, then you need to split the dose.

    Sometimes, you’re splitting the dose because it’s for comfort. The dose is big and it’s uncomfortable, so splitting it into two smaller injections can be more comfortable. And occasionally, under medical supervision, the dose is split to achieve specific glucose targets.

    Most recently, we’ve seen the introduction of GLP-1 receptor agonists and insulin in a single delivery device. What that means is that we have to think about how we should be injecting these combination products.

    So, first of all, insulin is part of that combination. So, good injection technique including proper rotation, and using a fresh needle each time. Second, is these devices often come with their own needles. So, we need to respect that, because often the size of the needle is related to the size of the molecule that’s being delivered.

    If the needle looks like it might be too long for your body type, talk to your healthcare professional about how you can properly use that injection needle to deliver your dose. We continue to learn more about lipohypertrophy all the time, so some recent studies have helped us to understand how long it might take for lipohypertrophy to resolve. It’s about three to six months, in most cases, but everybody’s lipohypertrophy is different.

    What’s important is that you remember a few things. Moving away from your areas of lipohypertrophy can mean that you will actually need less insulin. So, talk to your healthcare team about how to safely move into fresh tissue. The other thing is that you want to make sure that you’re having your area assessed, to make sure that there is no more lipohypertrophy before you start to use it again.

    Injection technique matters, but it should be individualized, so make sure that you talk to your diabetes healthcare team about an injection technique and rotation pattern that works for you. Diabetes Now Insulin Injection Technique Patient Communication System

    Presenter: Lori Berard, Nurse, Winnipeg, MB

    Local Practitioners: Nurse

  • Safe and Effective Insulin Injection Technique

    Before you give your insulin injection, the first thing that you should do is gather your supplies and wash your hands. The next step is preparing your insulin pen for injection. It’s very important that you use a new needle each time that you’re going to do an injection, and also it’s really important that you prime your pen.

                            

    So typically, we prime the pen with two units, but some manufacturers recommend three. Know what your pen recommends for a priming dose. What you do is you take off the outer cap of the pen needle. After you’ve screwed it on, you take off the outer cap, you take off the inner cap.

    You dial in whatever the recommendation is from the manufacturer, whether it’s two or three units. Holding the pen upright, you depress the plunger until you see a drop of insulin at the tip of the pen. Return the dose to zero, and now you’re ready to prepare your dose.

    After your pen is primed, you should dial in the dose that you’re required to take. Next, you’re going to pick the site that you’re going to use. Make sure the site is clean, and that you’re not injecting into any area of lipohypertrophy. Then, you’ll inject your pen needle in a 90-degree angle into the site that you’ve chosen, depress the plunger, hold it down for 10 seconds.

    Once that’s done, you’ll remove the insulin pen in the same angle in which you inserted it. Your injection is now complete, next you should take your outer cover of your pen needle to remove the pen needle and put it in the sharps container.

    So, helpful tips for you as you move forward with your injections is always rotate your sites and rotate within your sites. There’s a lot of space that you can use within each injection zone. Also, you want to make sure that you’re using a clean needle each time that you’re injecting, and if you have any questions about that you should be asking your healthcare provider. Diabetes Now Insulin Injection Technique Patient Communication System.   Often seeing a Endocrinologist or  local family physician  in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health.   

    Presenter: Lori Berard, Nurse, Winnipeg, MB

    Now Health Network Local Practitioners: Nurse

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