Insulin Administration 1

How to Safely and Properly Administer Insulin Injections

Carly Greenwood

Jayme Ritchie

Daziana Velasquez

Savannah Osborne

Youngstown State University

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Abstract

This paper explains the group of people who are at risk for needed insulin

injections, signs of hypoglycemia, testing the glucose and then safely administering it. It also

entails ways to lower your glucose without the insulin injections for those who still have a

functioning pancreas by describing a healthy lifestyle and diet.

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Reasons for Choosing Insulin Administration

Diabetes is an increasing issue within our society and because it is so common so it is

important for people to know how to safely administer insulin. Giving insulin at the wrong time

or giving too much or too little insulin could have detrimental effects on the body. This would

also give them more information about the insulin that they would be administering, so the

individual would be aware of side effects of too much or too little insulin. There is also a large

population who have a fear of needles and shots and this information could potentially help them

overcome their fear.

Comparison of the Procedure Done in the Home that Differs from Acute Care Setting

The process of actually giving insulin injections are the same within the hospital and

home health care. The major difference is that within the hospital or acute care setting, a nurse

typically gives the injection while in home health care, the patient may be responsible for giving

themselves insulin which is why it is so important for them to know how to do it correctly.

Type of Documentation that Would Be Required

The home health care agency would most likely have to document whether they gave the

shot the day or if the patient did. The site of the injection, the time it was given, the type of

insulin and how many units given would all be important to document for the home health care

agency.

Presentation

Just like any other disease, certain people are at risk for developing diabetes more so than

others. Some people are born more likely to develop diabetes than others. Genes alone are not
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enough to be diagnosed with diabetes. Although, some parents are so nervous that they will pass

down diabetes to their children. However, studies have shown that “if you are a man with type 1

diabetes, the odds of your child developing diabetes are 1 in 17.” (2014) As for women the risk is

much less for type 1 diabetes: “your child was born before you were 25, your child's risk is 1 in

25; if your child was born after you turned 25, your child's risk is 1 in 100.” (2014) On the other

hand, type two diabetes is different. It essentially “runs” in the family. In other words, your

children learn bad eating habits, not exercising, not drinking proper amount of water, etc. The

genetic aspect is different for both male and females. If you are a female, the chance of your

child getting type two diabetes is at a much higher risk if you, the mother, have type two

diabetes. Also if both parents have type two diabetes, the child has a 1 in 2 chance of getting it as

well. Studies have shown that, “if you have type 2 diabetes, the risk of your child getting

diabetes is 1 in 7 if you were diagnosed before age 50 and 1 in 13 if you were diagnosed after

age 50.” (2014) Another type of diabetes is gestational. Most people think that their children will

have diabetes if they develop gestational diabetes during their pregnancy. However, that isn’t

true. They are no more likely to develop diabetes than any other babies. Although, the mother is

at an increased risk for developing type two diabetes later on in life.

Other key factors that affect your risk for type two diabetes include age, race, gender, and

family history. As you age your risk increases, as it does for much like any other disease. African

Americans, Mexican Americans, American Indians, Native Hawaiians, Pacific Islanders, and

Asian Americans are all groups of people who are at a much higher risk for developing type two

diabetes. This is primarily because these groups are more likely to be overweight, have

hypertension, and eventually develop type two. Another important aspect is family history. If
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your dad, mother, grandpa, grandma, uncle, aunt, etc have diabetes then you are at higher risk of

developing diabetes compared to those whose family has no history of it.

Different ages depend primarily on who is administering the insulin and how exactly it

needs to be administered. As for children, many parents biggest fear is having to inject their child

with insulin. Most people are just nervous about the needle in general, and the thought of having

to poke their little baby or toddler every day, kills them. Both parents should be skilled and

understand exactly how to properly administer the insulin. Also, babysitters and grandparents

should know in case of an emergency or if they happen to be watching the young child. By

showing no fear in needles, the child will learn to adapt to that as well. Parents should typically

try to say they need this shot to grow and be able to play or something along the lines so they

understand the importance of it. Parents could also give out hugs after every shot. There is no

certain age as to when children can give themselves their own insulin. Typically, “by 9 or 10

years of age, they have the physical ability to draw up and give their own insulin.” (2010)

Teenagers/young adults adapt to giving themselves insulin overtime. However, they should have

some kind of supervision just to make sure they are giving the correct dose, switching injection

sites, and to make sure it is actually being injected. The ultimate goal is to make sure they have a

good understanding of how to give their own insulin because as they get older they go on

sleepovers, parties, vacations, etc. They will need to know how to administer it themselves in

those situations.

On the other hand, older adults usually rely on other caregivers to give them the insulin

and to monitor their blood glucose levels. Therefore, when they are in assisted livings, nursing

homes, or have a home health care nurse come to the house they have the advantage of those

nurses being able to monitor their diabetes. However, if the elders live on their own they must
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know the importance of checking their blood glucose regularly and properly giving the correct

amount of insulin.

As previously stated, certain individuals are more at risk for diabetes and would therefore

need insulin injections; there are also many different forms of diabetes. Diabetes comes in many

different variations, but there are three main types, Type one is Juvenile Diabetes, type two is

called Adult Diabetes and third is called Gestational Diabetes. While all three can be very

dangerous there are many ways out there to control them and also noticing different symptoms. It

is very important for the individual to recognize these symptoms because they have implications

if left untreated.

The first type of diabetes is Juvenile Diabetes, Type 1. This can happen when your

immune system destroys cells in your pancreas called beta cells, which make insulin. Another

form of type one can also be called secondary diabetes where the immune system doesn’t destroy

your beta cells but get wiped out by something else, like a disease or injury to your pancreas.

Some signs and symptoms you should notice with Type 1 diabetes are dehydration, Weight

Loos, Diabetic Ketoacidosis, and damage to your body.

Type 2 Diabetes is when the pancreas makes insulin but their cells don’t use it as well as

they should which is known as insulin resistance. At first your pancreas will try to make more

insulin to try to get glucose into the cells but soon it will not keep up, which causing it to build

up in your blood. Some signs and symptoms can be very thirsty, peeing a lot, blurry vision, being

irritable, tingling or numbness in your hands to feet, feeling worn out, and a very important

wounds that don’t heal.

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The third one is Gestational Diabetes. Pregnant women who have never had diabetes

before but who have high blood sugar levels during pregnancy are said to have gestational

diabetes. This occurs during pregnancy because the while the placenta is supporting the baby to

grow, hormones from the body help the baby develop. Due to that, hormones from the placenta

help the baby develop. But hormones also block the action of the mother’s insulin in the body.

The body ends up not able to make and use all the insulin. Because gestational diabetes does not

cause symptoms, you need to be tested for the condition. This is normally done between 24th and

28th week of pregnancy.

Once diagnosed with diabetes requiring insulin injections, patients should become

familiar with what types of insulin can be injected. Lispro (Humalog) is a short acting insulin

with an onset of 5-15 minutes, so food should be readily available. Humilin R is a regular acting

insulin and has an onset of 30-60 minutes and is the only insulin that can be given IV. Humilin N

is an intermediate acting insulin and has an onset of 1-2 hours but lasts about 18-24. Lastly there

is Glargine (Lantus) which has an onset of about 1 hour and lasts for 24.

Prior to administering any form of insulin it is important to check blood sugar levels to

see if the insulin is needed. The best time for a diabetic to check blood glucose is in the morning,

before eating breakfast. This is a fasting blood glucose and if the results come back between the

ranges of 80-130, the insulin injection may not be needed depending on the parameters set by the

doctor. In order to test glucose, the patient will need a glucometer, a testing strip and a lancet. To

begin, have the patient wash their hands and then decide which finger they would like to use in

order to draw blood for the testing. Place the testing strip inside the glucometer so it is ready

prior to drawing blood. Take one finger and clean with an alcohol swab on the side near the nail

and let it dry. Press the lancet to the finger and push down in order to prick the finger. Wipe
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away the first drop of blood with an alcohol swab and then collect the second drop of blood on

the testing strip and then wait for the results to appear on the screen of the glucometer.

Depending on what the blood sugar levels are will determine how much insulin is given.

Most of the time a sliding scale is used to determine how much insulin is given. For

example, if blood sugar levels are 220, 4 units of insulin may be given. Before administering

insulin, you have to draw up the correct amount and type of insulin. To begin, you will need a

needle, syringe and insulin. Attach the needle and syringe and draw up 4 units of air. Clean the

top of the vial containing the insulin and insert the needle. With the needle in the air portion of

the vial, not touching any fluids, insert the air and then flip the vial upside down to draw put 4

units. Remove the needle and then recap it and prepare the skin for injection which would be in

subcutaneous tissue, most commonly in the abdomen. Be sure to rotate sites because multiple

injections in one site could cause atrophy, or death of the tissue. Clean the skin with an alcohol

swap, pinch the skin with opposite hand and inject the needle at a 45-90 degree angle. Next, you

push down on the plunger to administer the insulin and remove the needle the same way you put

it in. Cover any bleeding with an alcohol swab and push the safety up on the needle and throw in

the sharps container.

In order to keep blood sugars under control along with insulin injections, individuals with

diabetes can choose a certain diet and activity level. A diabetics diet should consist of mainly

protein, grains, starchy vegetables and healthy fats. There are plant based proteins such as beans

and nuts, and poultry should include turkey and chicken instead of red meat. Another source of

protein includes cheeses and eggs. When choosing grains, look for whole grains which is a great

source of fiber, vitamins and minerals. Healthy fats should be included in a diabetic diet

including, monounsaturated fats, polyunsaturated fats and omega- 3 fatty acids. Along with a
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healthy diet, exercise is recommended to help keep blood sugars low. Both aerobic exercises,

such as walking, dancing, hiking, swimming, and strength training exercises should be included

at least two days a week.

Other complications could arise with diabetes: neuropathy, nephropathy, cardiovascular

disease, retinopathy, foot damage, skin conditions, hearing impairment and Alzheimer’s disease.

It is recommended that diabetic patients do not cut their own toe nails, any cuts caused with the

toe nail clippers could be a difficult to heal. They are also recommended to check their lower

extremities frequently for any cuts or ulcers. Due to their possible neuropathy, they may not have

feeling within their legs to see if there is any damage. Diabetic patients are also more likely to

develop kidney damage and atherosclerosis.

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