Human Monotard Humulin Lente Hypurin Bovine Lente

Figure 50 Over 300 insulin preparations are available worldwide. They may be classified according to their duration of action: short-acting (soluble, neutral or regular), intermediate-acting (isophane), long-acting (insulin-zinc suspensions), and fixed mixtures of short- and intermediate-acting (biphasic insulins). Some of the most commonly used insulins are summarized in this figure. It is preferable for the non-specialist to become familiar with a small number of appropriate insulins and insulin regimens rather than attempt to know them all

Biphasic Insulin Needles

Figure 5 1 Modern plastic insulin syringes carry integral fixed needles and are designed to minimize dead space. Recent advances in needle manufacturing have resulted in very fine needles, which have greatly reduced the discomfort of insulin injection. Patients usually use the same syringe and needle for several injections

Figure 5 1 Modern plastic insulin syringes carry integral fixed needles and are designed to minimize dead space. Recent advances in needle manufacturing have resulted in very fine needles, which have greatly reduced the discomfort of insulin injection. Patients usually use the same syringe and needle for several injections

Novo Rapid 3ml

Figure 52 Illustrated here are the Novopen® 3 Classic and two Novopen Fun insulin pens with an assortment of 3 ml insulin cartridges, which are inserted into the pens. Such pens are now the most popular method of administering insulin. Originally developed for multiple-dose regimens using short-acting soluble insulin, they are now available with cartridges of intermediate-acting isophane or fixed mixtures of insulins for injection twice-daily. The particular advantages of these pens are convenience, speed and ease of injection as well as less pain owing to the development of very fine tipped needles. Disposable insulin pens are also available. Also shown is the Innovo® insulin doser device that allows the patient to dial-up the correct dose of insulin and displays the previous dose and the time passed since its delivery

Picture Novomix InsulinNovomix Insulin
Figure 53 Insulin pens with preloaded cartridges are a popular method of insulin administration. The Flexpen® is one such pen and is a 3 ml preloaded delivery device for NovoMix® 30 and NovoRapid® insulins. It has tactile markings on the dose delivery button
Novomix Insulin Pens

Figure 55 This novel pre-filled disposable device (Innolet®) has a plastic palm-held doser with a large 'eggtimer like' dial for dosing and is particularly useful for diabetic patients with hand problems or visual impairment

Figure 54 The Humapen® Luxura insulin pen which has just been released exemplifies the user-friendly convenience of modern insulin pens which can be fitted into a jacket pocket or handbag lnL-026

Figure 55 This novel pre-filled disposable device (Innolet®) has a plastic palm-held doser with a large 'eggtimer like' dial for dosing and is particularly useful for diabetic patients with hand problems or visual impairment

Insulin Administration Sites

Figure 56 Usual sites of insulin administration are the outer thighs, buttocks, upper arms and abdomen, and should be rotated within each anatomic area as injection into exactly the same site may cause lipid hypertrophy (see Figure 64), which may hinder insulin absorption. Insulin absorption may vary from one site to another

Figure 56 Usual sites of insulin administration are the outer thighs, buttocks, upper arms and abdomen, and should be rotated within each anatomic area as injection into exactly the same site may cause lipid hypertrophy (see Figure 64), which may hinder insulin absorption. Insulin absorption may vary from one site to another

Skin Swab Arm

Skin Fat

Muscle

Figure 57 Insulin injection technique: the modern practice is to insert the needle vertically into the subcutaneous tissue. Needles of 8 mm in length are used with a pinch-up technique except in obese patients, in whom the standard 12-mm needle should be used. When insulin is being injected without pinch-up into the arms, 6-mm needles are recommended. It is no longer considered necessary to swab the skin with alcohol or to withdraw the skin plunger to check for blood. Care must be taken in thin patients to avoid intramuscular injection as this will result in more rapid absorption of insulin

Skin Fat

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