Insulin Administration

Subcutaneous Injections: Insulin

Carefully select the ordered insulin and syringes. Note that there are many different types of insulin with different rates of onset, peak, and duration of action.
                   

Mixing two insulins in one syringe: Humulin R + Humulin N

  *Note: Different brands and types of insulin may not be able to be mixed in one syringe. For example Lantus has to be administered by itself and cannot be mixed.  

Roll the vial of Humulin N to mix the contents.
Do NOT shake the vial.
 
Wipe the top of both vials
 
 

Inject the same amount of air into the vial of Humulin N as the ordered dose.
 
Inject the same amount of air into the vial of Humulin R as the ordered dose.
 
 

Withdraw the ordered amount of Humulin R
 
Withdraw the ordered amount of Humulin N
Sample:

Humulin R 15 units
Humulin N 12 unitsTotal = 27 units

Inject 12 units of air into the Humulin N vial
Inject 15 units of air into the Humulin R vial
Withdraw 15 units of Humulin R (be very careful to get rid of all the air bubbles)
Withdraw 12 units of Humulin N (you will have a total of 27 units in the syringe; 15 + 12 = 27). This dose must be exact. If you draw back beyond the 27 unit mark, you have to start completely over.

Note what syringe you are using. The markings vary between syringes. Only insulin syringes are used for administering insulin injections.
Rule to Remember: Never contaminate a vial of regular insulin with any other type of insulin, since regular insulin is also used for IV administration.

A mneumonic to help you remember the order is:

Long Short Short Long
Air into the long Air into the short Draw up short Draw up long
Cloudy Clear Clear Cloudy


Administering Insulin

Things to consider before administering insulin:

  • What was the capillary blood sugar level?
  • When will the patient be eating?
  • Site to be used?
  • Type of insulin to be administered. Onset? Duration?

  1. Wash hands and don gloves
  2. Identify patient
  3. Do third medication check
  4. Cleanse site with antiseptic swab
  5. Grasp skinfold at site (needle needs to be 1/2 the depth of the skinfold top to bottom)
  6. Inject needle quickly and firmly at a 45-90 degree angle. (The angle depends on the skinfold thickness. Use the angle necessary to administer the injection at the base of the skinfold. In general if you "pinch an inch", use a 90 degree angle). Do NOT aspirate.
  7. Slowly inject the insulin, withdraw needle
  8. Do NOT massage site.
  9. Slide end needle protection cap over end of needle and place syringe into sharps container.
Using a safety syringe:

OSHA regulations require the use of safety syringes. There are several different types.

           

Additional Resources:

The Healing Handbook for Persons with Diabetes:
http://www.umassmed.edu/diabeteshandbook/intro.htm

Insulin:
http://www.umassmed.edu/diabeteshandbook/chap08.htm

Webcast:
http://webcasts.prous.com/ADA2006_PGCourse/index2.asp?sec=5

American Diabetes Association
http://www.diabetes.org

National Diatbetes Education Initiative
http://www.ndei.org/

Novo Nordisk
http://www.novonordisk.com/

Hoffman-LaRoche Healthcare Providers
http://www.roche-diagnostics.com/healthcare/index.html

Lantus Insulin
http://www.drugs.com/pdr/Lantus_Injection.html