But insulin is a life-saving medicine and it is prescribed only when oral medications are no longer effective. Taking insulin injections is not difficult once you get used to it; your doctor or diabetes nurse or educator will initially help you to learn the injection technique. For very small children parents can learn how to administer insulin, but older children, adolescents and adults can learn to take their insulin injection themselves. This makes insulin therapy effective and successful.

Injection site

Since insulin needs to be taken daily 3 – 4 times a day it is best to alternate the insulin injection sites. You could take the insulin injection in the abdomen, thighs or back of the upper arm. Though, for taking injection in the upper arm you may require assistance.

Remember that insulin is absorbed most rapidly when injected on the abdomen, followed by the arm and most slowly from the thighs. Due to this difference in absorption rate from different sites use the same part of the body for each of your daily injections. For example, take all the morning doses in the abdomen, afternoon doses in the arm and evening injections in the thigh. To prevent formation of hard lumps below the skin it is good to alternate within injection sites. Keep each of your pricks at least two finger’s width from the last prick.

Right technique

Injecting at the proper depth is an important part of good injection technique. It has to be injected in the fatty layer beneath the skin but just above the muscle. If you inject too deep, the insulin could go into the muscle, where it’s absorbed faster and the effects will not last so long.

While if the injection is not deep enough, the insulin goes into the skin, and it takes longer for it to start acting. You could pinch up a fold of skin and insert the needle at an angle between 45° and 90° in the skin fold. If you use a 4 – 6mm mini pen needle to inject, you don’t have to pinch up the skin. Simply inject at a 90° angle.

• Before injecting wash your hands thoroughly and have your insulin, syringe or pen, cotton and alcohol ready.
• Roll the vial of insulin, especially if it is a milky one, about 10 – 15 times between your palms and clean the top of the vial with alcohol.
• Draw in air according to the number of insulin units.
• Push this air in the insulin vial and draw insulin into the syringe.
• If you have been recommended intermediate acting and short acting insulin, they can be mixed in the same syringe. The short acting insulin is always drawn into the syringe first.
• Make sure there is no air in the syringe before injecting.
• After injecting, wait for 10 seconds before you withdraw the needle.
• You can eat 30 minutes after injecting your insulin if you use human insulin and if you use modern insulin you can eat immediately.
• Insulin syringes must be matched with correct strength of insulin.
• Do not use alcohol to clean your needle as this removes the coating that helps the needle slide into the skin easily and makes injection painful.

Storage of insulin

Insulin that’s improperly stored or past its expiration date may not be effective. Ideally insulin should be stored at 2 – 8°C. Once opened, a vial of insulin should ideally be used within three months. If not refrigerated, a vial should be used within one month of opening. If a refrigerator is not available, for instance when you are travelling, then store the insulin in a cool place, like a properly sealed plastic bag kept in a bowl filled with water or a cloth bag dipped in water and hung in a ventilated and shady place.

Injecting cold insulin can sometimes make the injection more painful. To avoid this, you can keep your syringe and bottle of insulin at room temperature for 5 – 10 minutes before using.

Do not store your insulin near extreme heat or extreme cold. Never store insulin in the freezer or expose it to direct sunlight.

Reuse of syringe

Although all needles and syringes are recommended for single use, for the purpose of administering insulin you may want to reuse syringes as that could be more economical. However, discuss this with your doctor or nurse before you begin reusing. Do not reuse if you are ill, have wounds on your hands, or have poor resistance to infection. If you plan on reusing your syringe keep the needle capped at all times when you’re not using it. Never let the needle touch anything other than your disinfected skin and the top of the insulin bottle. Never let anyone use a syringe you’ve already used, and don’t use anyone else’s syringe.

This was first published in the September 2012 issue of Complete Wellbeing.

The post A prick in time appeared first on Complete Wellbeing.

A for active life

Take up a physical activity you enjoy—walking, jogging, dancing, swimming or cycling—on a regular basis. Experts recommend engaging in 30 – 45 minutes of physical activity [moderate intensity] to reduce your risk of obesity, blood pressure, heart disease and other lifestyle disorders. It is also important to stay active throughout the day.

B for balanced diet

Six small meals instead of two or three large ones make it easier to control diabetes. Limit your intake of overtly sweet and fried foods. Instead include whole grains, pulses and nuts, vegetables, fruits, and low-fat milk products in your diet—they are good for people with diabetes. Eating adequate fibre every day helps. A traditional Indian meal that contains salad, vegetables, dal, whole wheat flour chapattis or brown rice with little modifications is best.

C for cutting down alcohol

Limit alcohol consumption to two drinks for men and one drink for women. One drink equals 300ml if it’s a beer, 150ml if it’s wine and 45ml if it’s distilled liquor.

D for diagnosis

When fasting blood glucose levels go over 126mg/dl or 2-hour postmeal blood sugar levels go over 200mg/dl, a person is diagnosed with diabetes. If fasting level is between 100mg/dl – 125mg/dl, or postprandial level is between 140mg/dl – 199mg/dl, this indicates that one has pre-diabetes, which means that she is at risk of developing diabetes if she does not adopt a right lifestyle.

F for foot care

Pay close attention to your feet to catch anomalies like a cut, a sore, a blister, or a bruise in time. Consult your doctor for any problems, even if they are small. Wear shoes that protect your feet from all sides and that aren’t an effort to wear. Diabetics should get their feet checked at least once a year for changes in sensation, circulation and to rule out infection.

H for HbA1c

HbA1c [glycated haemoglobin] is a test that measures average blood glucose over 2 – 3 months. People with diabetes need to maintain their HbA1c level between 6 and 7 to avoid developing diabetes-related complications. At the time of diagnosis, if the HbA1c count is more than 9, or at any time in spite of taking two or three oral diabetes medications, the HbA1c count is more than 7.5, then you may need to take insulin. An HbA1c test is best done every three months or at least twice a year.

I for insulin

Insulin is a hormone that our body produces to help process sugar. If the body cannot produce insulin or produces less insulin, a person develops diabetes. Some of us make it in our body and others have to take it from outside. If no matter what you do, your HbA1c count keeps rising, you may have to start insulin therapy.

M for medicine

Those with type-1 diabetes need insulin injections every day. There are mainly two types of insulin—conventional human insulin and modern insulin analogues. Insulin analogues are more predictable and safe and also provide convenience and flexibility as they can be taken just before or even after eating. People with type-2 diabetes too may require tablets and some may even need insulin. In addition, there are other treatments that help keep blood sugar levels in control, which the doctors prescribe depending on one’s blood sugar levels, age, weight, and health complaints.

N for new therapies

e.g. GLP-1 analogues. This therapy helps control diabetes and lowers systolic blood pressure. However, don’t self-medicate as only your doctor can judge the treatment that suits you.

S for stop smoking

Smoking is bad for diabetics as it ups their chances of developing complications such as stroke and heart disease. It also affects blood circulation.

T for tests

You need to undergo tests to keep a check on your condition. These tests include: blood pressure measurement whenever you visit your doctor, lipid profile, eye examination and urine exam among other tests. Your doctor may ask you to do more tests as and when required.

W for weight

Maintain a healthy BMI. If you are slightly overweight, lose up to 5 per cent – 10 per cent of your body weight as losing weight helps your body use insulin better. Even if you lose a little weight, your chances of diabetes reduce significantly, so does your risk of heart diseases, high blood pressure and stroke.

Diabetes, if not controlled, can lead to serious long-term complications like heart disease, stroke, kidney failure, blindness, amputations and other conditions. Treatment of diabetes requires maintaining blood sugar levels within normal range with the help of medications, exercise, and diet. Any medication is only a part of the diabetes treatment plan and cannot be a substitute for a healthy diet and exercise. The best way to live happily with diabetes is to take an active part in your treatment plan.

This was first published in the November 2011 issue of Complete Wellbeing.

The post A-B-C of diabetes appeared first on Complete Wellbeing.