Diabetes Injection Guide
The South County Hospital Diabetes Center locations: • • •
Wakefield, 70 Kenyon Ave., 02879, lower level Westerly, 268 Post Road, 02891 East Greenwich, 3461 South County Trail (Route 2), 02818
Call the South County Health Diabetes Center to schedule an appointment or to learn more about your diabetes at 401-788-1135 or 401-788-1696.
WELCOME This packet is being given to you as a guide. Because diabetes is progressive, it may mean that you are being prescribed a different treatment for your diabetes Your doctor/medical provider will determine whether Insulin or GLP‐1 receptor agonists are needed. Both of these are injections GLP‐1 is a natural hormone that is released from your small intestines when you eat GLP‐1 injections help your body produce more insulin when your blood sugar is high GLP‐1 helps to slow down how quickly food leaves your stomach and slows down increases in blood sugar GLP‐1 helps to keep the liver from releasing too much sugar into your blood
Insulin is a hormone made by your pancreas When you have diabetes, your body either doesn’t make insulin or the insulin you make doesn’t work right Sugar (glucose) cannot get into your cells without insulin helping it. So, sugar (glucose) stays in your blood and builds up Insulin must be injected. It cannot be taken by mouth (it would be digested in your stomach and intestines and never get into your cells). You can get the insulin you need by injecting it with an insulin pen, a syringe or insulin pump
Where you can inject
Each blue area in the chart above is a place where you can inject Do not use the exact same site the next time you inject Only use syringes or pen needles one time A re‐used needle can become dull and may cause a more painful injection
Storing Insulin Keep unopened insulin (vials or unused pens) in the refrigerator, but do not freeze When you open a vial or pen of insulin, store it at room temperature (Keep out of direct sunlight) and write the date on the vial or pen Do not use after the expiration date
What should my blood sugar numbers be?
Always discuss your personal blood sugar goals with your Doctor/Medical Provider This is a guide from the American Diabetes Association: Before a meal (before breakfast,lunch,dinner) After a meal (1‐2 hours after the first bite of the meal) Bedtime
80 mg/dl‐ 130 mg/dl Less than 180 mg/dl 90 mg/dl‐ 150 mg/dl
Take control of your treatment plan and work with your diabetes team to manage your diabetes. You can learn to live well with diabetes. There are resources at the South County Health Diabetes Center to help you live well with your diabetes.
Call to schedule an appointment to learn more about your diabetes 401-788-1135 401-788-1696
How Do I Test My Blood Sugar At Home? The best way to tell if your blood sugars are high or low is with a blood sugar meter You and your doctor will decide when you need to check your blood sugar and how often it should be done Your blood sugar readings will show you how food, activity, stress, illness and medications affect your blood sugar every day
Properly dispose of your syringes and needles and lancets Do not try to recap, bend or break the needle Place the used syringe into a hard, non‐puncture proof plastic container such as an empty laundry detergent or bleach bottle Store the container safely away from children and pets When the bottle is filled, tape the top and place the filled container in the center of your regular trash DO NOT PLACE THE CONTAINER IN RECYCLING These disposal guidelines are acceptable in the state of RI but may be different for you if you are in another state. You can check for your specific needle disposal guidelines with your Department of Health or your pharmacy
Call to schedule an appointment to learn more about your diabetes 401-788-1135 401-788-1696
How to check your blood sugar
Wash your hands with soap and warm water.
Rinse well. Gently rub your hands to warm them.
Put the test strip into your meter.
Prick the side of your finger. Apply the blood to the test strip.
Write the results in your book. Don't forget to share the results with your diabetes team.
HOW TO PREPARE
SINGLE DOSE INSULIN 1. Wash hands with warm, soapy water.
2. If using cloudy insulin (NPH, 70/30, 75/25, 50/50), roll bottle between hands.
3. Clean rubber stopper of insulin bottle with alcohol.
5. Insert needle into the bottle and push air into the insulin bottle.
6. Turn syringe and bottle upside down and draw out your dose of insulin.
4. Fill syringe with air equal to the number of units of insulin you will be taking.
Provided by South County Health Š 2011 Learning About Diabetes, Inc. All rights reserved. Rev. 2015
HOW TO PREPARE
MIXED DOSE INSULIN 1. Wash hands with warm, soapy water.
2. If using cloudy insulin, roll bottle between hands.
3. Clean rubber stopper of insulin bottle with alcohol.
4. Fill syringe with air equal to the number of units of NPH (cloudy) insulin you will take. Insert needle into the NPH bottle. Push the air into bottle. Remove the needle.
5. Fill syringe with air equal to the number of units of fast-acting (clear) insulin (Apidra, Humalog, Novalog, Regular) you will use. Insert needle into the fast-acting insulin bottle and push air into bottle. Do not remove needle.
6. Turn bottle upside down. Draw out (pull down the plunger) the units of fast-acting (clear) insulin you need. Remove needle from the fast-acting bottle.
7. Insert the needle into the N (cloudy) insulin bottle. Do not push the plunger up! Draw out (continue to pull down the plunger) the units of N insulin you need to get your total dose of insulin. (Clear + N = Total Dose) Provided by South County Health Š 2011 Learning About Diabetes, Inc. All rights reserved. Rev. 2015
HOW TO USE AN
INSULIN PEN Pick the Place (Site) to Inject Sites to inject include: • Back of upper arms • Stomach (around navel) • Front and side area of thighs • Back above waist • Rear end (buttocks) Stay 1 inch away from the last few injection sites. Stay 2 inches away from the navel and any scars. Do not use sites that are bruised, tender, swollen or hard to the touch.
Taking Your Insulin 1. Clean the skin with an alcohol pad. Let the alcohol air-dry. 2. Take the cover off the pen. You can see the insulin in the pen.
3. If you are using a cloudy insulin, gently roll the pen between your hands to mix the insulin. 4. Use alcohol to clean the end of the pen where the needle twists on.
5. Peel back the cover on the needle. Screw the needle onto the pen. The needle should be snug but not too tight.
6. • • • • •
To clear the air out of the pen: Remove the cap from the needle Turn the dose dial to 2 units Hold the pen so the needle is up in the air Push the end of the pen in to clear the air Watch the tip of the needle for a drop of insulin. You may need to do this more than once to see the drop of insulin on the needle.
7. To set your dose of insulin, turn the dial clockwise until you see the number for your insulin dose.
8. With one hand, pinch and hold the skin at the site where you will inject the pen. 9. Push the needle straight into the skin in a straight, quick motion. The needle should be all the way into the skin. 10. Using your thumb, push the end of the pen down slowly until your dose of insulin is in. Make sure the needle is all the way in the skin before pushing in the insulin.
11. Let go of the pinch of skin. Wait a few seconds. 12. Pull the needle out. 13. Remove the needle from the pen. Throw it into the needle disposal container. 14. Put the cover back on the insulin pen. Talk to your doctor or diabetes-care provider if you have any questions about using your insulin pen.
Provided by South County Health © 2014 Learning About Diabetes, Inc. All rights reserved. Rev. 2015
Symptoms of Hypoglycemia Low Blood Sugar Blood Sugar:
• Below 70 or 80 mg/dl Onset:
• Can be sudden Causes:
• Too little food • Skipped a meal or snack • Too much diabetes medicine or insulin
What Can You Do? Step 1: CHECK
Step 2: TREAT
Check your blood sugar. If you are at 80 mg/dl or less, go to Step 2: TREAT
Take 4 oz. of juice or regular soda or eat 3-4 glucose tablets or 5-6 fruit candies. Follow to Step 3: CHECK.
Step 3: CHECK
Step 4: EAT
Check Blood Sugar again in 15 minutes. If sugar is below 80 mg/dl, repeat Step 2: TREAT. If blood sugar is over 80 mg/dl, go to Step 4: EAT.
Within 30 minutes, eat your regular scheduled meal if planned. If no meal is planned, eat 4-6 peanut butter crackers or a granola bar.
• Extra physical activity • Drinking alcohol Prevent low blood sugar by:
• Spacing meals 4-5 hours apart • Taking medications or insulin as prescribed • Work with your diabetes educator for a physical activity plan • Discuss alcohol use with your doctor and diabetes educator
Call your doctor if blood sugar stays below 80 mg/dl for two readings.
prescribed.
Symptoms of Hyperglycemia High Blood Sugar Blood Sugar:
• 240 mg/dl or above Onset:
• May be gradual Causes:
• Too much food • Too little insulin or diabetes medicine • Being sick • After surgery or dental work • Under stress
What Can You Do? Step 1: CHECK
Step 2: DRINK
Prevent high blood sugar by:
• Eating healthy • Being active • Taking medications/insulin as prescribed
Check your blood sugar. If you are 200 mg/dl or more, go to Step 2: DRINK
Drink 1 – 2 glasses of water and go to Step 3: CHECK
Step 3: CHECK
Step 4: CALL
• Checking blood sugar regularly • Talk to your doctor and diabetes educator about your diabetes regularly
Check to make sure you are taking your diabetes medications or insulin as
Call your doctor if your blood sugar is 240 mg/dl or above after two readings.
M T W Th F S Su
M T W Th F S Su
M T W Th F S Su
M T W Th F S Su
Day
Breakfast Before 2 hr after Before
Lunch 2 hr after
Before
Dinner
ADA Targets for Blood Glucose: Before meals: 80 to 130 mg/dl. Two hours after the start of a meal: below 180 mg/dl
Date
South County Health - Blood Glucose Record 2 hr after
Bedtime
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