Injecting Insulin

Injecting insulin is the essential part of the daily regime for many Diabetics patient. Although insulin that can be inhaled is now available and approved, the reality is that most type 1 diabetics (and type 2 diabetics who require insulin) will have to continue injecting insulin until it is more common.

Tips for Injecting Insulin

Injection sites: Insulin should be injected into the layer of fat that lies right under the skin. There are several areas on the body where you can inject your insulin. These include the:

Abdomen (Stomach), a few inches away from belly button
Outer thigh
Hips
Upper Buttocks
Back of the arms

Painful Injection: Now a day’s super thin needles are available in the market, Insulin injection are pretty much painless, If you are finding that your injection hurt’s, Try the followings;

Use a new needle for every injection. It’s tempting to reuse needles, but they can become dull even after just one or two injections. And the duller the needle, the more painful the injection.
Use the thinnest needle possible. The higher the gauge, the thinner the needle.
Use a short needle (6 mm or shorter).
Inject insulin at room temperature.
If you use alcohol to clean your injection site, make sure it’s completely dry before injecting.
Relax tense muscles make the nerves in the injection area more sensitive.
Larger doses of insulin (30 units or more) may be uncomfortable. If this is a concern, talk with your doctor about splitting your dose.
Rubbing ice on your skin before injecting may also help.

Insulin leaking from injection sites: It’s not unusual for insulin to leak out from the injection site after you withdraw the needle. Usually, the amount that leaks out is insignificant and likely won’t affect your blood sugar levels. To minimize or avoid leakage, try the following:

Count slowly to 10 before withdrawing the needle.
After removing the needle, place your finger on the site for 5–10 seconds.
If you use a pen, always remove the needle after you inject. Leaving the needle on can cause air to enter the cartridge and it will take longer to inject the insulin.
Try injecting at a 45-degree angle rather than going straight in.

Forgetting to take you insulin: Missing even just one injection per week can raise your HbA1c level by 0.5%. How can you remember?

Link taking your insulin with other daily habits, such as eating breakfast or brushing your teeth before you go to bed.
Keep your insulin and supplies in a convenient place. And think about keeping supplies both at home and at work (or school).
Don’t get distracted. Multitasking is never a good idea, especially when it comes to injections. If you’re doing too many things at once, you can easily forget to inject. Focus on the task at hand.
Set an alarm, use sticky notes, ask your spouse to remind you — all can help you to remember.

Fear of Needles: Injection can lead to anxiety and even physical symptoms, such as light-headedness, palpitations, dry mouth, sweating, and feeling sick. Here’s what can be helpful:

Make sure you’re using the shortest, thinnest needle that you can.
An insulin pen may be easier for you to use than a syringe.
Put a cold spoon or an ice cube on the injection site for a few minutes before you inject.
Ask your doctor about using a topical anesthetic, which can numb the surface of the skin.

To read more on Patient Care, click on the link below.

Patient Care

Content Courtesy : Portea

I Need Insulin

My doctor is insisting on Insulin, what do I need to know ?

Insulin is produced in our body naturally by the pancreatic cells and helps the body in converting sugar into energy. When our body produces insufficient or no insulin then doctors recommend taking Insulin additionally, to ensure body metabolises carbohydrates into sugar, and sugar does not accumulate for a prolonged period of time in the form of blood glucose.

There are myths associated with taking Insulin, read below to find out the most frequently asked questions by people living with diabetes.

I have been asked by my doctor to take Insulin, is my Diabetes getting worse ?

Taking Insulin does not necessarily mean that your Diabetes is getting worse. To control your high blood glucose levels your doctor may prescribe Insulin therapy. By not taking the Insulin therapy you may further develop Diabetes-related complications such as Glaucoma in the eyes and malfunctioning of the kidneys or the liver, neuropathy, foot problems, nerve related issues etc. People with Type 2 Diabetes often use combined therapy of medicine and Insulin to keep their sugar levels in control.

Will injecting Insulin be painful ?

Injecting Insulin is not as painful as you may think. Your doctor will direct you how to inject Insulin in the right way and painlessly. Insulin should be given in the areas where one has more flab and less muscle. There are many new types of syringes which are thinner and painless to use, so this should not be a cause for worry.

Once I begin Insulin, will I have to take it for the rest of my life ?

The answer to this question is different for different types of Diabetes. For people living with Type 1 Diabetes this is true; however, for people with Type 2 Diabetes, studies have shown that taking medication on time, physical exercises and diet control can lead to reversal of the condition. Some people simply do not want to start Insulin because of the fear of having to take it forever. However studies have revealed that once the blood glucose levels are under control, patients have been able to switch back to oral medication and no longer have to depend on Insulin.

Travelling with Insulin is tedious, can I miss my injections ?

Doctors all round the world strongly recommend that people who are Insulin dependent must not miss any injections. If you miss your regular dose, it will disrupt the ground you have gained in Diabetes management and take you back to square one. Your blood sugar levels will shoot up and create an imbalance of toxins in the body, leading to further complications.

It is a good idea to make your own small back-pack where you could keep your syringes, Insulin, cotton, gauze and astringent handy. Insulin has to be kept in a cool place and, hence, sometimes needs to be refrigerated. If you are travelling, check with your pharmacist for new types of Insulin pens and cartridges, which might not need refrigeration.

What I can do as family/friend of a person living on Insulin ?

If your partner has Insulin-dependent Diabetes, we understand that you would have your own set of stresses that can be mentally and physically exhausting. You would need to be able to support your partner in different ways, such as establishing and maintaining a healthy diet and exercise routine, checking your partner for wounds that may be concerning, learning to give Insulin shots correctly and painlessly, as well as routinely check blood glucose levels.

There are quite a few things that you can do to help yourself and your partner. First and foremost, in order to support your partner in living with this condition, you need to take care of yourself, both mentally and physically. Establish a health plan for yourself, which will keep you in good shape to deal with the stresses that go along with Diabetes. It is even better if you can exercise together. Taking up meditation and yoga is also a very good way to reduce the impact of stress on your body.

You do not need to give up your life and pleasures in order to support your partner. For example, develop a balanced diet plan that takes care of your partner’s nutritional requirements, but do not forget to add your favourite dish to the equation!

Consult with your doctor to plan an evening out, away from the regular routine. Understand and follow the doctor’s instructions when it comes to dos and don’ts for eating and drinking on your evening out, and you will be fine.

Make sure to have a backup for yourself. As you support your partner in living with Diabetes, you need not give up your interests. Have family/friends provide you with backup whenever you need to step away for some time. This also takes care of the condition known as “compassion fatigue” in caregivers.

It is also good to have support of other people living with this condition just in case you yourself are under the weather for a couple of days.

To read more on Diabetes, click on the link below.

Diabetes

Understanding Diabetes

What is Diabetes?

Diabetes is an endocrine disorder that elevates your blood sugar levels over a prolonged period of time. It is caused by the malfunctioning of the pancreatic cells, which produce insufficient or no Insulin.

Why is Insulin so vital ?

Insulin is the hormone that is responsible for the process that converts carbohydrates into sugar; which is then stored it in the body for future use. Insufficient or no secretion of insulin from our pancreas leads to an imbalance in the body, causing liver cells to convert glycogen to glucose and accumulate in the blood stream.

Indications of Diabetes

Some of the most common symptoms suggesting the onset of diabetes are frequent urination, frequent thirst, frequent hunger (even after full meals), unexplained burning, itching or rash in the body, specially the foot, bruising easily, slow healing of wounds or clotting of blood when the skin is broken/cut, tingling or numbness sensation in the extremities of the feet and hands as also extremely low energy levels. However, often these symptoms could go unnoticed leading to undetected diabetes. Hence, it is always a good idea to get yourself regularly checked by a doctor for preventive healthcare.

Why did I get Diabetes?

Leading Endocrinologist Dr Sanjay Kalra from Bharti Hospital, Karnal shares his perspective on why diabetes is spreading like an epidemic. Nearly 70 million Indians are living with diabetes today. This is not a small number. Our genetic make-up is tuned such as to store fat reserves in the body in order to survive severe weather conditons such as famine. In ancient times, these stored food reserves or lipids were converted into energy in the bodies of our ancestors, so that they could survive the harsh living conditions. Cut to the present generations, lifestyle, stress levels, sedentary life, lack of physical activity, unhealthy diets, all contribute to surplus reserves for the body. As a result, the pancreas gets overworked and starts malfunctioning.

Am I at Risk?

There are several factors which may cause diabetes but medical science is yet to ascertain the main cause responsible for a specific person. However research indicates that the following conditions make people twice more likely to get diabetes than those without these conditions.

It could be genetic, family history has a strong role. Other factors such as obesity, high blood pressure high triglyceride levels, presence of diabetes autoantibodies, substance abuse, or excessive consumption of alcohol and tobacco.

Diabetes Ranges

Age 20 and above amounts shown as mg/dL
Fasting	Less than 100
Before Meal	70-130
After Meal (1–2 hrs)	Less than 180
Before Exercise	If taking insulin at least, 100
Bed time	100-140
HbA1c	Less than or around 7.0 %

SOURCES: American Diabetes Association. “Standards of Medical Care in Diabetes—2014,” Diabetes Care, January 2014.

Shown above are blood glucose ranges defined by American Diabetes Association. You’re kindly advised to refer to a doctor as the values may differ slightly with different age & gender.

What is Prediabetes?

When the blood glucose levels are borderline or higher than what they should be. But not as high as people with diabetes is known as Prediabetes. This condition is a “whistle blower” and indicates that you may proceed towards diabetes type 2, if you do not make the necessary changes in your lifestyle.

What are the Types of Diabetes?

You may have already undergone tests and your doctor may have already explained if you have Diabetes, and if so, the specific type you are living with. As a general understanding, the following classifications should give a sense of various types of diabetes:

Type 1 Diabetes:
- Type 1 diabetes is when there is insufficient or no production of insulin in the pancreas. This condition requires external insulin to help your body convert sugars to energy.
Type 2 Diabetes:
- Type 2 diabetes is when the pancreatic cells, become insulin resistant due to a defective response in the receptor cells in the body. This is the most commonly found type worldwide.
Gestational Diabetes:
- Gestational diabetes is when blood sugar levels are raised during the time of pregnancy. This is most likely a temporary condition, in which blood sugar levels are often likely to come back to normal after the delivery.
Latent autoimmune diabetes in adults:
- LADA is when autosomal alterations can lead to defective BETA cell function, resulting in Type 1 diabetes. LADA is often misdiagnosed as Type 2 diabetes in India.

Complications

Diabetes is called as a silent killer because many people remain undetected till such time as the consistently high blood glucose levels start affecting other organs such as the heart, the kidney and the liver – referred to as Macro-vascular complications and the nervous system resulting in foot, gum or vision problems called Micro-vascular complications.

Check for other important co-morbid conditions:

Diabetic Retinopathy
Kidney Disorders
Diabetic Neuropathy
Chronic Vascular Disease
Liver Disorders
Erectile Dysfunction
Polycystic Ovarian Disease

What else do I need to know ?

Often many people remain undetected till such time that consistently high blood glucose levels have already started affecting other organs such as your heart, kidney, liver – referred to as Macro-vascular complications, and your nervous system resulting in foot, gum or vision problems called Micro-vascular complications.
If you are “suffering” from any other life style conditions, “co-morbid conditons” consult your endocrinologist/ diabetologist. Your doctor will prescribe specific medications and solutions to manage this or any other complication.