Insulin Pens

( Precise Injection Techniques )

BY

KHALED EL SAYED EL HADIDY. MD Head of Internal Medicine Department.

Head of Diabetes and Endocrinology Unit.Beni-Suef University.

Treatment options in type 2 diabetes

1960s 1970s 1980s 1990s

Sulphonylureas

Thiazolidinediones

DPP-4i, dipeptidyl peptidase-4 inhibitor; GLP-1RA, glucagon-like peptide-1 receptor agonist; SGLT2i, sodium glucose co-transporter-2 inhibitor

Metformin

1950s

Insulin

GLP-1 RAs

DPP-4is

SGLT2is

2000s 2010s

Barriers to Initiation of Insulin Therapy

• Heath care providers

• Lack of consensus

• Limited local resources

• Inconsistent training

• Self-monitoring

• limited time for patient education regarding proper insulin administration techniques

• Patient challenges

• Hypoglycemia

• Weight gain

• Self-monitoring

• Complexity of treatment

• Injection technique

• Perceived ‘failure’

Fear of Hypoglycemia

Insulin Therapy Barriers*

Carlos Campos, MD, MPH, South Med J. 2007;100(8):804-811

v

Patients who improved their technique for insulin resuspension had significantly Fewer Hypoglycemic episodes than those that did not improve their technique.

Insuman the most efficient human insulin to resuspend to ensure accurate dosing*.

J Diabetes Sci Technol Vol 4, Issue 3, May 2010

Complexity of treatment

Insulin Therapy Barriers*

Carlos Campos, MD, MPH, South Med J. 2007;100(8):804-811

Injection technique

Insulin Therapy Barriers*

Carlos Campos, MD, MPH, South Med J. 2007;100(8):804-811

Attach the needle to a pen

Prime your insulin penbefor each injection.

Insulin Administration (Using an Insulin Pen)

Turn dose knob to correct insulin dose

Inject insulin by pushing on dose knob; hold for 10 seconds

Throw pen needle away in a sharps container

Pinch skin

Rotation schedule

Painful injection

Insulin Dripping from Pen Needle after Injection, or Insulin Leakage at Injection Site

• not leaving the needle under the skin long enough.

So count slowly to 10 before withdrawing the needle.

• not pinching up the skin correctly.

So Make sure that you release the pinch before

you remove the needle from the skin.

• not carry a pen with the needle attached - this

causes air to enter the cartridge, slowing the

time it will take for you to get your insulin dose.

So get rid of needle after injection.

Bleeding at the Injection Site

stopped by

1- Don't rub the spot.

2- Maintain light pressure with your finger to prevent bruising.

3- If a bruise does appear, don't use that injection site again until the bruise is gone.

Take Home Message

Thank you