Insulin administration

Question 1

What layer is subcutaneous insulin injected into?

Answer 1

Subcutaneous fatty layer

Question 2

What could happen if insulin is injected to deeply i.e. into muscle?

and what could happen if insulin is injected to superficially ?

Answer 2

Hypoglycaemia could occur as it could be absorbed directly into the bloodstream and act too quickly

Could result in hyperglycaemia as some of the insulin may seep out and not be absorbed

Question 3

What are the main injection sites for insulin ?

Answer 3

The abdomen

Upper outer thigh

Upper outer arm

Some will inject in the buttock region at home

Question 4

What is generally advised for insulin injection?

Answer 4

That the same insulin is injected in the same site each day (e.g. long acting in the abdomen), whilst also ensuring that in each injection area rotation occurs

Question 5

Why should you check the injection sites regularly ?

Answer 5

Because problems can arise such as lipohypertrophy - insulin absorption at this site would be poor hence injections here should be avoided

Question 6

What size of needle should be used to inject insulin ?

Answer 6

4-8mm

Question 7

Subcutaneous oedema (in e.g. heart, liver, kidney disease) can have a real affect on insulin absorption and hence injection should be avoided in oedematous areas - T/F?

Answer 7

True

Question 8

What are the concentrations of insulin used ?

Answer 8

Usually it is 100 units per millilitre - rarley though it can be higher conc (e.g. U500, which is 500units per millilitre)

Question 9

What must healthcare professionals enusre they use when administering insulin ?

Answer 9

An insulin syringe (has a total volume of 1 millilitre) and a vial of insulin

Question 10

What are disposable pens used for in insulin treatment ?

Answer 10

They are used for self management - after all the insulin is used in one it is disposed off

Question 11

How are cartridge pens reused ?

Answer 11

The cartridge is replaced after all the insulin has been used

Question 12

What is insulin pump therapy also known as ?

Answer 12

Continuous subcutaneous infusion of insulin (CSII)

Question 13

What should be put in place on discharging someone newly taking insulin ?

Answer 13

Appropriate support/ referral to district nursing service

and they have the correct insulin and insulin delivery service (e.g. disposable pen)

Question 14

How should insulin be prescribed ?

Answer 14

• Should be prescribed in both the drug prescription chart and insulin prescription chart
• Insulin prescription chart also contains info on the blood glucose monitoring
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Question 15

If the charts do not have the word ‘units’ pre printed what should you do ?

Answer 15

You should only write out the words units beside the dose NOT the abbreviation U as this could confuse the dose given e.g. 10 units, 10U where the U is mistaken for an extra 0 then the wrong dose is given

Question 16

Why Should ‘STAT’ or one off doses of insulin to correct hyperglycaemia generally be avoided unless by a senior doctor or specialist ?

Answer 16

Because they can precipitate hypoglycaemia

Question 17

Should people with diabetes admitted to hospital be given the choice to manage their own insulin ?

Answer 17

Yes - as the often have more knowledge about it than most healthcare professionals

Question 18

What insulin should not be stored in the ward fridge ?

Answer 18

Any open/in use devices as this could cause cross contamination