Insulin Therapeutics 1 W3 Flashcards
What are the aims of insulin therapy?
To treat hyperglycaemic without causing hypoglycaemia
To reduce the risk of long-term complications and enable a patient to maintain a normal lifestyle with adequate diabetic control
Two types of insulin
Porcine = pig
Bovine = cow - no longer available
Five main types of insulin
- Rapid acting analogue e.g. Novo rapid, humalog
- Short acting e.g. humulin.S
- Medium and longer acting e.g.Humulin.I, lantus, levemir
- Analog mixture e.g. Novo mix 30.
- Humulin M3
Administration of insulin
Subcutaneous injection/IV for emergencies
Needles
Vile and syringe/reusable or disposable penalises/insulin pump
Tell me about syringes
Graduated in units
1ml = 100 units (for most insulin)
Fixed needle
Available as 1ml, 0.5ml and 0.3ml
Smaller are used for children
There is some new insulin which have different strengths, what are these?
◼ Insulin glargine 300 units/ml (Toujeo®)
◼ Insulin lispro 200 units/ml (Humalog® 200)
◼ Insulin degludec 200 units/ml (Tresiba ®)
What is insulin pump?
a small electronic device that releases the regular insulin your body needs through the day and night — so you don’t need to do insulin injections.
Needle lengths
◼ 5mm
◼ 6mm
◼ 8mm
◼ 12mm
◼ 12.7mm
Needle gauges
◼ 25G (0.5mm)
◼ 26G (0.45mm)
◼ 27G (0.4mm)
◼ 28G (0.36mm)
◼ 29G (0.33mm)
◼ 30G (0.3mm)
Why only use a needle once?
Reuse of needle deforms it which leads to local complications at the injection site like lipodystrophy, bleeding and infection.
Choice of needle size: slim
5 or 6mm
Choice of needle size: moderate
6 or 8mm
Choice of needle size: large
12 or 12.7mm
8mm needles insulin syringe
◼ 0.3ml, 0.5ml, 1.0ml
◼ 29G (0.33mm), 30G (0.3mm)
12mm needles insulin syringe
◼ 0.3ml, 0.5ml, 1.0ml
◼ 26G (0.45mm), 27G (0.4mm), 28G (0.36mm), 29G
(0.33mm)
Needles for pen devices length and gauge
◼ Length:
5mm, 6mm, 8mm, 12mm, 12.7mm
◼ Guage:
29G, 30G, 31G
Sites of administration
◼ Abdomen (fastest absorption),
◼ Thighs (slower absorption),
◼ Upper arms (medium to fast absorption)
◼ Buttocks (slowest absorption)
◼ Short and long acting in separate sites
*Rotate sites to avoid lipohypertrophy *
lipohypertrophy
Thickening/hardening of injection area
Injection technique
◼ Inject into clean skin with clean hands (do not use alcohol wipes)
◼ Inject into soft fat not muscle at 90º angle
◼ “Pinch up” if slim or injection site with little subcutaneous fat OR use shorter needle
◼ Push needle all way in & leave for 5-10 secs to avoid leakage
