Insulin injections are not just for type 1 diabetics any more. Millions of people who have adult-onset, type 2 diabetes are being advised by their doctors to use insulin to prevent stress on the pancreas that can, ironically, make daily insulin injections essential for life.
Insulin is the one medication for diabetes that always lowers blood sugars, but it is easy to use insulin in ways that lower blood sugars too much. It's also easy to make mistakes that keep insulin from working at all. Here are ten important ways for any diabetic who uses insulin to avoid preventable diabetic disasters.
- Be sure to invert the insulin vial while filling the insulin syringe. A surprisingly large number of new insulin users assume, not completely without a rational basis, that since every time they take insulin out of a vial, they push air in, that air pressure should force insulin into the syringe. It doesn't. Insulin flows into a syringe by the force of gravity. If the tip of the needle is not held directly under the vial of insulin, the syringe won't fill and the diabetic won't get the needed amount of insulin.
- Don't inject insulin into the same spot day after day. Over a few weeks so much scar tissue can build up that insulin gets trapped inside it, never reaching the bloodstream. Rotate insulin injection sites between the arms, the buttocks, the stomach, and the inner thighs.
- Don't skip an insulin injection just because you are sick. Many diabetics assume that when they have a "stomach flu" they don't need insulin because they are not eating. Actually, blood sugars can soar because of the infection even without regular meals. Take scheduled insulin injections, and be sure to take blood sugar readings so you know you are on track.
- Avoid multi-tasking while taking insulin. Typically, diabetics take 2 or 3 times more slow-acting insulin than fast-acting insulin. Taking 2 or 3 times more fast-acting insulin than slow-acting insulin, especially just before bedtime, can result in dangerously low blood sugars.
- Some diabetics who use an insulin pump get strange blood sugar readings when they sleep on heated water beds or under electric blankets. The heat from the bed or blanket expands the plastic tube that delivers insulin. More insulin flows into the catheter than normal, and blood sugar levels plunge. The solution for the problem is to keep the room warm so it is not necessary to use an electric blanket or to heat the water bed.
- If you go on a reduced-calorie diet and successfully lose weight, you will probably need to adjust your insulin injections. This is especially true for diabetics who go on liquid diets. The solution is to follow an insulin "scale" your doctor gives you, or at least to take blood sugar levels regularly to know when hypoglycemia may be imminent.
- Make sure you are using an insulin syringe when you take insulin. A tuberculin test syringe, for example, will deliver 10 times as much insulin in the same number of "units." It's always best to buy a box of syringes and keep them separate from any other syringes used for any other purpose by you or any other member of your household.
- Check mail order insulin carefully. It's not unheard of for mail order pharmacies to send "asparaginase" (which is not insulin) instead of the kind of insulin known as insulin aspart. Compare labels on new vials and old vials if necessary.
- Beware the difference between U-100 insulins, used in North America, and U-500 insulins, used in the rest of the world. U-500 insulin is five times stronger than U-100 insulin, and taking U-500 when U-100 is intended can result in dangerously low blood sugar levels.
- If you have been using an insulin pen and you switch to insulin syringes to save money (lots of money, if you don't have insurance), be sure to draw insulin from the vial by holding it directly over your syringe. An insulin pen is used on its side, but an insulin vial has to be held over the syringe to fill it with insulin.
And if you don't have diabetes but you have a pet that does, keep glucose tablets on hand just in case you accidentally inject yourself when you are trying to inject your pet. The small amount of insulin given a dog or a cat can cause severely low blood sugar levels in healthy people, requiring a trip to the ER that can be prevented just by taking a few glucose tablets.
