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Following an Injection PREPARING FOR INJECTION 1. Wash your hands. Text Continues Below
2. To avoid tissue damage, choose a site for each injection that is at least ½ inch from the previous injection site. The usual sites of injection are abdomen, thighs, and arms. 3. Cleanse the skin with alcohol where the injection is to be made. 4. With one hand, stabilize the skin by spreading it or pinching up a large area. 5. Inject the dose as instructed by your doctor. 6. After dispensing a dose, pull the needle out and apply gentle pressure over the injection site for several seconds. Do not rub the area. 7. Immediately after an injection, remove the needle from the Humulin 70/ 30 Pen. Doing so will guard against contamination, leakage, reentry of air, and needle clogs. Do not reuse needles. Dispose of needles in a responsible manner. DOSAGE Your doctor has told you which insulin to use, how much, and when and how often to inject it. Because each patient's case of diabetes is different, this schedule has been individualized for you. Your usual insulin dose may be affected by changes in your food, activity, or work schedule. Carefully follow your doctor's instructions to allow for these changes. Other things that may affect your insulin dose are: Illness Illness, especially with nausea and vomiting, may cause your insulin requirements to change. Even if you are not eating, you will still require insulin. You and your doctor should establish a sick day plan for you to use in case of illness. When you are sick, test your blood glucose/ urine glucose and ketones frequently and call your doctor as instructed. Pregnancy Good control of diabetes is especially important for you and your unborn baby. Pregnancy may make managing your diabetes more difficult. If you are planning to have a baby, are pregnant, or are nursing a baby, consult your doctor. Medication Insulin requirements may be increased if you are taking other drugs with hyperglycemic activity, such as oral contraceptives, corticosteroids, or thyroid replacement therapy. Insulin requirements may be reduced in the presence of drugs with hypoglycemic activity, such as oral hypoglycemics, salicylates (for example, aspirin), sulfa antibiotics, and certain antidepressants. Always discuss any medications you are taking with your doctor. Exercise Exercise may lower your body's need for insulin during and for some time after the activity. Exercise may also speed up the effect of an insulin dose, especially if the exercise involves the area of injection site (for example, the leg should not be used for injection just prior to running). Discuss with your doctor how you should adjust your regimen to accommodate exercise. Travel Persons traveling across more than 2 time zones should consult their doctor concerning adjustments in their insulin schedule. COMMON PROBLEMS OF DIABETES Hypoglycemia (Insulin Reaction) Hypoglycemia (too little glucose in the blood) is one of the most frequent adverse events experienced by insulin users. It can be brought about by: 1. Taking too much insulin 2. Missing or delaying meals 3. Exercising or working more than usual 4. An infection or illness (especially with diarrhea or vomiting) 5. A change in the body's need for insulin 6. Diseases of the adrenal, pituitary or thyroid gland, or progression of kidney or liver disease 7. Interactions with other drugs that lower blood glucose, such as oral hypoglycemics, salicylates (for example, aspirin), sulfa antibiotics, and certain antidepressants 8. Consumption of alcoholic beverages Symptoms of mild to moderate hypoglycemia may occur suddenly and can include: ° sweating
° drowsiness
° dizziness
° sleep disturbances
° palpitation
° anxiety
° tremor
° blurred vision
° hunger
° slurred speech
° restlessness
° depressed mood
° tingling in the hands, feet, lips, or tongue
° irritability
° lightheadedness
° abnormal behavior
° inability to concentrate
° unsteady movement
° headache
° personality changes Signs of severe hypoglycemia can include: ° disorientation
° seizures
° unconsciousness
° death Therefore, it is important that assistance be obtained immediately. Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions, such as long duration of diabetes, diabetic nerve disease, medications such as beta-blockers, change in insulin preparations, or intensified control (3 or more insulin injections per day) of diabetes. A few patients who have experienced hypoglycemic reactions after transfer from animal-source insulin to human insulin have reported that the early warning symptoms of hypoglycemia were less pronounced or different from those experienced with their previous insulin. Without recognition of early warning symptoms, you may not be able to take steps to avoid more serious hypoglycemia. Be alert for all of the various types of symptoms that may indicate hypoglycemia. Patients who experience hypoglycemia without early warning symptoms should monitor their blood glucose frequently, especially prior to activities such as driving. If the blood glucose is below your normal fasting glucose, you should consider eating or drinking sugar-containing foods to treat your hypoglycemia. Mild to moderate hypoglycemia may be treated by eating foods or drinks that contain sugar. Patients should always carry a quick source of sugar, such as candy mints or glucose tablets. More severe hypoglycemia may require the assistance of another person. Patients who are unable to take sugar orally or who are unconscious require an injection of glucagon or should be treated with intravenous administration of glucose at a medical facility. You should learn to recognize your own symptoms of hypoglycemia. If you are uncertain about these symptoms, you should monitor your blood glucose frequently to help you learn to recognize the symptoms that you experience with hypoglycemia. If you have frequent episodes of hypoglycemia or experience difficulty in recognizing the symptoms, you should consult your doctor to discuss possible changes in therapy, meal plans, and/ or exercise programs to help you avoid hypoglycemia. Hyperglycemia and Diabetic Acidosis Hyperglycemia (too much glucose in the blood) may develop if your body has too little insulin. Hyperglycemia can be brought about by: 1. Omitting your insulin or taking less than the doctor has prescribed 2. Eating significantly more than your meal plan suggests 3. Developing a fever, infection, or other significant stressful situation In patients with insulin-dependent diabetes, prolonged hyperglycemia can result in diabetic acidosis. The first symptoms of diabetic acidosis usually come on gradually, over a period of hours or days, and include a drowsy feeling, flushed face, thirst, loss of appetite, and fruity on the breath. With acidosis, urine tests show large amounts of glucose and acetone. Heavy breathing and a rapid pulse are more severe symptoms. If uncorrected, prolonged hyperglycemia or diabetic acidosis can lead to nausea, vomiting, dehydration, loss of consciousness or death. Therefore, it is important that you obtain medical assistance immediately. Lipodystrophy Rarely, administration of insulin subcutaneously can result in lipoatrophy (depression in the skin) or lipohypertrophy (enlargement or thickening of tissue). If you notice either of these conditions, consult your doctor. A change in your injection technique may help alleviate the problem. Allergy to Insulin Local Allergy — Patients occasionally experience redness, swelling, and itching at the site of injection of insulin. This condition, called local allergy, usually clears up in a few days to a few weeks. In some instances, this condition may be related to factors other than insulin, such as irritants in the skin cleansing agent or poor injection technique. If you have local reactions, contact your doctor. Systemic Allergy — Less common, but potentially more serious, is generalized allergy to insulin, which may cause rash over the whole body, shortness of breath, wheezing, reduction in blood pressure, fast pulse, or sweating. Severe cases of generalized allergy may be life threatening. If you think you are having a generalized allergic reaction to insulin, notify a doctor immediately. ADDITIONAL INFORMATION Additional information about diabetes may be obtained from your diabetes educator. DIABETES FORECAST is a national magazine designed especially for patients with diabetes and their families and is available on subscription from the American Diabetes Association, National Service Center, 1660 Duke Street, Alexandria, Virginia 22314, 1-800-DIABETES (1-800-342-2383). Another publication, DIABETES COUNTDOWN, is available from the Juvenile Diabetes Foundation, 120 Wall Street 19th Floor, New York, New York 10005-4001, 1-800-JDF-CURE (1-800-533-2873). Additional information about Humulin and Humulin 70/ 30 Pen can be obtained by calling 1-888-88-LILLY (1-888-885-4559). Literature revised October 8, 2003 Manufactured by Lilly France S. A. S. F-67640 Fegersheim, France for Eli Lilly and Company Indianapolis, IN 46285, USA Copyright 1998, 2003, Eli Lilly and Company. All rights reserved. PA 9144 FSAMP 6 Page: << Prev | 1 | 2 | 3 | 4 | 5
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