General Practice 2022

How to apply insulin: with a syringe or pen (and application sitesção)

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How to apply insulin: with a syringe or pen (and application sitesção)
How to apply insulin: with a syringe or pen (and application sitesção)

Insulin can be delivered with a syringe or via a pre-filled pen, however, the syringe remains the most common and cheapest method. In either case, insulin must be injected into the layer of fat under the skin, where it will be slowly absorbed, mimicking the production of the substance by the pancreas.

In addition, insulin can also be introduced into the body by an insulin pump, which is a small, portable electronic device that delivers insulin for 24 hours. Read more about how the insulin pump works.

1. Insulin with syringe

There are several sizes of insulin syringes, ranging from 0.3 to 2 ml capacities, depending on the range of units of insulin a person needs to make.

Generally, each ml can be divided into 100 units, but there are insulins that have 500 units in each ml and, therefore, the calculation of the necessary units must always be explained by the doctor, according to the type of insulin and blood glucose values. Once you know the value to inject, you should:

  1. Wash your hands to avoid soiling the insulin vial or carrying bacteria into the syringe;
  2. Put a sterile needle into a sterile insulin syringe;
  3. Disinfect the rubber of the insulin vial, passing a piece of cotton moistened with alcohol;
  4. Insert the syringe needle into the rubber of the insulin vial and turn the vial upside down so that the needle is immersed in liquid and does not draw air;
  5. Pull the syringe plunger until the correct number of units is filled. Usually, the syringe is divided with several risks that mean 1 unit and is marked every 10 units, to make the task easier;
  6. Remove the needle and syringe, capping the vial again if possible;
  7. Pull the skin using thumb and forefinger;
  8. Insert the needle completely into the crease, at an angle of 450 to 90º, with a quick and firm movement;
  9. Push the syringe plunger until all contents are released;
  10. Wait for about 10 seconds and withdraw the skin needle, releasing the skin fold after removing the needle.

When it is necessary to mix 2 types of insulin in the same syringe, you must put the fast-acting insulin in the syringe and only then add the slow-acting insulin, without needing to change the needle. Normally, fast insulin is clear and slow is whitish, similar to milk. Both insulins must be mixed before drawing into the syringe, it is recommended to roll the vials between both hands rather than shaking.

After application, the needle and syringe should be thrown in the trash or kept in a proper container for later delivery to the pharmacy and recycled. Whenever possible, the needle should be protected with the cap. No syringe or needle should be used in more than one application, as this may increase the risk of infection or reduce the action of the drug.

2. Insulin with pen

The pen is a more practical option than the syringe, however it is more expensive and therefore may not be used in all cases. To apply insulin correctly using a pen, you need:

  1. Wash your hands and have the injection site clean,and, if dirty, it may be necessary to clean the site with a compress or gauze soaked in alcohol;
  2. Gather all the necessary material, which includes pen prepared with insulin cartridge and needle and swab;
  3. Prepare the amount of insulin you should applyr by turning the pen and observing the number on the display. For example, if your doctor has indicated that you should take 4 units with dinner, you should rotate the pen until the number 4 appears;
  4. Pull in the skin using only the thumb and index fingers, mainly on the belly and thigh;
  5. Insert the needle, between 45º to 90º, with a quick and firm movement. As the needle is very small and is only inserted into the skin, it causes the sensation of a mosquito bite, not being painful, and a greater angle (90º) should be made the more body fat the person has;
  6. Push the plunger, or button all the way in to inject insulin;
  7. Wait up to 10 seconds before removing the needle from the skin, so that the liquid completely enters the body;
  8. Loosen the small fold of skin.

Usually, the application of insulin does not cause pain or cause changes in the skin, however, right after the insulin application, a tiny drop of blood may come out, not worrying, and can be wiped off with a compress.

Places for insulin application

Insulin can be applied to the belly, inner thigh, back of the arm and buttocks and is usually taken before eating, such as breakfast, lunch or dinner.

Application on the belly and thigh allows a skin fold to be made, but on the arm, the application can be done without a fold when performed by the person himself, as the movement is more complicated.

Its application should always be carried out in different places, each time, to avoid the accumulation of fat and make the skin sagging in the region, scientifically called lipodystrophy.

How to prepare the insulin pen

There are insulin pens that are disposable, which means that after finishing the amount of medicine that is inside the pen, it must be thrown in the trash and, therefore, they do not need to be prepared, it is only necessary turn the pen knob to the desired amount of insulin.

However, most pens need to be primed as soon as an insulin cartridge is used up, as they can be used over several years, so you need:

  1. Disassemble the pen by turning;
  2. Remove the empty insulin tank and insert a new bottle inside;
  3. Join the two parts of the pen;
  4. Attach a needle to the end of the pen;
  5. Test operation and see if a small drop of insulin comes out and remove any air bubbles that may be inside the bottle.

After the pen is assembled, the patient can use it until the product runs out, however, it is advised to change the needle daily, so as not to hurt the skin or cause infections.

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