Page 274 - fourth year book

DIABETES MELLITUS

for people who have trouble drawing up insulin out of two bottles and
reading the correct directions and dosages. It is also useful for those who

have poor eyesight and is convenient for people whose diabetes has been
stabilized on this combination.

 Administration of insulin:
 Insulin syringes

 Insulin pens.
 Insulin pumps.

 Inhaled insulin.
 Pancreas transplantation.

 Islet cell transplantation.

 Insulin injection sites:
 Sites for subcutaneous insulin injections include the upper arms,

upper thighs, abdomen, and buttocks. Absorption is fastest with
injection in the abdomen, followed by the arms, thighs, and

buttocks.
 The thigh is the preferred site for NPH insulin to ensure optimal

absorption, and may also be most desirable for nighttime injections
of all insulin types.

 Rotation of the injection site is critical to prevent lipohypertrophy
 Injection into moles and scars and within 2 inches from the

umbilicus must be avoided.

 Problems associated with insulin injections:

1. Many patients develop some blurring of vision soon after starting
insulin, which makes reading difficult. This is due to a change of
lens refraction, and it corrects itself within two to three weeks.

2. Transient edema of the feet is not uncommon during the first few

weeks of Insulin treatment
3. Fatty lumps at injection sites are common, their cause is not known
but they sometimes develop if injections are repeatedly given over

a very limited area of skin. For this reason it is best to vary the site

from day to day, if insulin is repeatedly injected into a fatty lump,
the rate of absorption may be delayed .

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