Insulin is a hormone released by the pancreas that helps the body use glucose from carbohydrates for energy. In type 1 diabetes, the pancreas fails to produce insulin, and in type 2 diabetes the body does not properly use insulin. High blood glucose levels over long periods can damage blood vessels and organs. Different types of insulin have varying onsets and durations of action to maintain normal blood glucose. Nurses must properly administer insulin subcutaneously, monitor blood glucose levels, and document care to safely manage diabetes.

2. Mechanism of action
 Insulin is a hormone that occurs naturally in the body
 carbohydrates are broken down into blood glucose,
 Which is where the body gets most of its energy
 The pancreas makes and releases insulin to help the body
use or store that glucose and reduce the blood glucose
level

3.  In type 1 DM the pancreas fails to make insulin
 In type 2 DM the body does not use the insulin properly
 Consistent high level in insulin causes blockage of
arteries vital organs and cause nerve damage , CKD ,CVA
,MI ,etc
 To prevent above mention disorder we administer insulin
to maintain blood glucose level

4. Types of insulin
 Rapid acting insulin : starts its action with in 5 minutes
and peaks at one hour. E.g. actrapid
 Short acting insulin : starts its action with in 30 minutes,
can be taken before meals. E.g. regular (Humulin R)
 Intermediate acting : often used with rapid or short acting
to take care of insulin needs over long period usually half
a day. E.g. NPH Insulin

5.  Long acting insulin : Its usually taken in the morning and
balance blood glucose level for a full day, used with rapid
or short acting insulin. E.g. lantus
 Pre-mixed insulin: mixes short acting and intermediate
acting insulin and is usually taken twice a day , just before
meals and used mainly for people who have difficulty
mixing there own insulin. E.g. human mixtard

6. Methods of delivery of insulin
 syringe
 Pen(preloaded insulin)
 Pump (continuous infusion)
Dilution for pump
50 units(0.5 ml) in 49.5 ml of NS
Each ml consist of one unit

7. Site of insulin administration
 Subcutaneous tissue
upper outer thigh
lower abdomen
upper outer `arm

8. Nurses role in insulin administration
 Insulin one of the high risk medication
 Nurse must ensure interpreting an insulin prescription
sheet
 Should have basic knowledge about action of insulin
 Confirm patient identity and dose
 Draw correct dose of insulin in the syringe

9.  Should have knowledge about site of insulin
administration
 Assess the site for lumpy areas
 Hold the syringe in 90 degree for subcutaneos insulin
administration
 Do not rub after insulin administration it may cause rapid
absorbtion
 Use standard dilution incase of pump

10.  Should have knowledge about use of glucometer to
monitor blood glucose
 Know to recognize and respond to hyper or hypoglycemia
 use separate vial for each patient
 The vial should be labeled basic information including
patient name, open date, etc
 Proper documentation is essential to prevent error