Guideline for Insulin Use

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February 1st, 2022

Guideline for Insulin Use

1. How to store insulin?

Unopened insulin (new) – Keep unopened insulin in the fridge or in a clay pot buried in wet sand.
Opened insulin (in use) – Insulin that is currently in use can be kept at room temperature (in a dark and cool place under 30ºC) for up to 30 days.
Do not expose insulin to direct sunlight or high temperatures. Do not leave it outside or in the car on a hot day or near the cooker. Do not freeze insulin! Never put insulin in a freezer compartment. Do not use insulin if it has expired.
Examine the vial or cartridge closely to make sure the insulin looks normal before it is drawn into the syringe.

Tips:

  • Keep spare vials or cartridges of insulin in their boxes in the fridge.
  • The first time an insulin vial is used, write the date on the bottle label.
  • Avoid shaking insulin bottles and insulin cartridges too much.

2. Where to inject insulin?

Insulin must be injected into the fatty layer just under the skin. There are four safe areas for insulin injections:
1. Thighs: Top and outer areas only. Do not use the inner side or back of the thighs.
2. Upper arms: Fleshy area on the side and back of the arms. Avoid muscle and shoulder.
3. Abdomen: Right across the abdomen, from just below the ribcage to below the belt line
4. Buttocks: The top outer area
Remember to do the injections in a different place each time, going in a circle around the body. Injecting in the same place over and over can cause the skin to swell.

3. Injecting Insulin.

Insulin vial
1. Wash and dry your hands.
2. Have a syringe.
3. Roll the insulin vial between your hands.
4. Draw air into the syringe.
5. Push air into the vial and then draw insulin into the syringe.
6. Make sure there is no air in the syringe.
7. Inject insulin in the correct part of the body.
8. Throw away the syringe in the proper container.
9. Put the insulin back into a cold place.

Never share syringe or needle with anyone.

Insulin pen
1. Wash and dry the hands.
2. Remove the pen cap.
3. Remove the protective pull-tab from the needle and screw the needle onto the pen.
4. Dial two units.
5. Hold the pen up with the needle pointing upwards, then press the injection button all the way until you see a drop of insulin at the needle tip. The dosage knob should be back at zero after completing this step.
6. Turn the dosage knob to dial the number of units of insulin you need.
7. With one hand, hold the pen so that your thumb is free to reach the injection button.
8. With the other hand, gently pinch up the skin around the injection site. Insert the needle at a 45 to 90-degree angle. Ask a doctor or nurse which angle is best. While keeping the needle under the skin, press the injection button all the way to zero. Keep pressing for 10 seconds.
9. Pull out the needle. Use an alcohol swab to press gently if the person bleeds when the needle is removed. Do not rub the injection site.
10. Replace the needle cap before unscrewing the needle from the pen. Never leave the needle on the pen when not in use.
11. Throw the used needle in a proper container.
12. Replace the pen cap and store the insulin pen into a cold place.

Never share syringe or needle with anyone.

 

HelloType1 content is based on published, internationally recognised guidelines and then reviewed by local experts to ensure it fits local context. The translation is based on simplified English language to ensure it conveys the safest and clearest possible message in regional languages. Basic insulin and blood glucose testing access is still an issue in the South-East Asia region and our chief aim is to address this. HelloType1 content is not intended to replace the advice of individual healthcare professionals but as a collaborative tool to help them improve the outcomes of disadvantaged people with Type 1 Diabetes in the region.


HelloType1 content is curated for the topics using information only taken from accredited sources such as the International Diabetes Foundation (IDF) and the International Society for Paediatric and Adolescent Diabetes (ISPAD).

This content is then reviewed and adapted by a panel consisting of healthcare experts (e.g. endocrinologist, nutritionist, diabetes nurse, psychologist) and members of the South-East Asia T1D communities, helping ensure the information is appropriate in a local context.

Writers of HelloType1 content:
Anne-Charlotte Ficheroulle, Pharmacist, Digital Innovation Manager at A4D
Charlotte O’Brian Gore, Research assistant ImmunoEngineering, King’s College. UK

Content Reviewers – healthcare professionals:
Dr. May Ng, Paediatric Endocrinologist, Chief Medical Advisor A4D, UK
Dr. Yeow Toh Peng, Endocrinologist, Malaysia
Dr Jaturat Petchkul, Paediatric Endocrinologist, Thailand
Dianna Culbertson, Physician Assistant T1D care, US
Prof Dr Malene Iv, Endocrinologist, Kantha Bopha Hospital, Cambodia
Steffen Tange, Consultant Psychology, Denmark
Soe Nyi Nyi, Nutritionist, Myanmar
Lucas Lim, Dietician, Malaysia

Content Reviewers – people with Type 1 Diabetes:
Jerry Gore, Co-Founder A4D, Mountaineer, UK
Diana Maynard, T1D advocate, UK
Emelyne Carmen Ho, College Student, Malaysia
Molly Seal, College Student, UK

Content Reviewers – parents with T1D child:
Samantha Seal, Teacher, Thailand
Kim Than, Deputy Country Director – Plan International, Cambodia

https://www.diabetes.org/diabetes/medication-management/insulin-other-injectables/insulin-storage-and-syringe-safety

https://www.novonordisk.com/content/dam/Denmark/HQ/sustainablebusiness/performance-on-tbl/Acess%20to%20care/CDiC/pdf-patients/CDIC_ENG_patient_handout.pdf

https://www.healthhub.sg/live-healthy/1432/how-to-use-an-insulin-pen

https://kidshealth.org/en/teens/injection-graphic.html?WT.ac=ctg

https://www.uofmhealth.org/health-library/aa122700

Read more

What is insulin and what are the different types?

What is insulin and what are the different types?

What are the guidelines for blood glucose monitoring?

What are the guidelines for blood glucose monitoring?

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How to inject with Insulin vial?

How to inject with Insulin vial?

How to inject with Insulin pen?

How to inject with Insulin pen?

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