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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
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
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
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.