The document provides a comprehensive overview of insulin therapy, including its definition, types, indications, administration procedures, and potential side effects. It emphasizes the importance of insulin in managing diabetes by controlling blood sugar levels and outlines the roles of healthcare professionals in administering insulin. Specific details regarding storage, equipment needed, site selection for injections, and contraindications are also discussed.

1. INSULIN THERAPY
FARWANIYA HEALTH REGION
STAFF DEVELOPMENT UNIT

2. OBJECTIVES
At the end of the session the nurses will be able to
• Define the insulin therapy.
• Enumerate the indications of insulin therapy.
• Discuss the types of insulin and its preparation.
• Determine the sites of insulin administration.
• Mention the equipment that needed for insulin injection.
• Discuss the procedure of insulin administration.
• List down the side effects of insulin therapy.
• Enumerate the contraindications of insulin therapy.

3. • Insulin is a small protein
molecule and a naturally-
occurring hormone secreted
by the beta cells of the
pancreas.
• Insulin controls the amount of
blood sugar by moving it into
the cells, where it can be used
by the body for energy.
INTRODUCTION

4. HOW THE INSULIN WORKS IN OUR BODY
Body
doesn't
make
insulin
Cant use the
insulin, it
does
produce
Combin
ation of
both
Healthy Individual
Body break down
sugars and
carbohydrates
Special sugar
called Glucose
Fuels the cells In your Body
Cells needs INSULIN (hormone)
in blood stream to take up the
glucose and use it for energy
IN DIABETES MELLITUS
Since the cells cant take up
the glucose
Glucose buildup in your
Body
High Blood glucose
damage the thin blood
vessels in Kidney,
Heart, Eyes & Nervous
system
Type
11
Type
1

5. INSULIN THERAPY
All type 1 and some type 2 diabetics require insulin
replacement to achieve glycemic control, using mixture
of short acting, intermediate and long-acting insulins
administered as subcutaneous injection

6. INDICATIONS FOR INSULIN THERAPY
Type 1 diabetes
Women with gestational diabetes
In type 2 diabetes, inadequately controlled on OADS
Treatment of hyperkalemia.
Type 2 diabetes in special situations
• Pancreatitis
• DKA
• During surgery
• Acute infections

7. TYPES OF INSULIN
•
Regular insulin
Humulin R
Novolin R
Lispro (Humalog)
Aspart (NovoLog);
Insulin glulisine (Apidra)
NPH insulin
Humulin N
Novolin N
Insulin glargine
(Lantus);
Insulin detemir
(Levemir).
Short-acting
Intermediate-
acting
Long-acting
Rapid-acting

8. TYPES OF INSULIN (CONT.)
1- RAPID-ACTING (INSULIN
ASPART) 2-SHORT-ACTING HUMULIN
(REGULAR)

9. TYPES OF INSULIN (CONT.)
 INTERMEDIATE-ACTING (NPH).
 PREMIXED (70/30 )

10. TYPES OF INSULIN (CONT.)
 LONG-ACTING LANTUS-
(GLARGINE).LEVEMIR(DETEMIR)

12. STORAGE OF INSULIN
Refrigerate if not in use
2° to 8°celcius (36° to 46°fahrenheit)
Excess agitation should be avoided.
Specific storage guidelines.
Insulin in use may be kept at room
temperature.
Expiration date is stamped on each vial of
insulin.
Inspect the bottle before each use for
changes.

13. INSULIN ADMINISTRATION SITES
 Abdomen & gluteal region (Fastest
absorption & most preferred)
Upper outer arm (intermediate
absorption )
 Thigh-lateral & anterior
aspects(slowest absorption)
 Rotate the sit of injection around
the selected area

14. INSULIN ADMINISTRATION PROCEDURE
Equipment
• Prescription sheet
• Insulin bottle
• Syringe
• Alcohol pads.
• Kidney basin
• Sharps disposable box
• small tray

15. Before administration
• Identify the patient and explain the procedure
• Check the patient general condition for any contraindication
• Reassure the patient.
• Maintain the individuality and provide comfort, safety, and
privacy
• Observe vial for any change in color.
• Follow 10 rights of administration of any medication.
• Check expiry date is 2 years from manufacturing date.
• Position according to the procedure and patient condition
INSULIN ADMINISTRATION PROCEDURE
(CONT.)

16. INSULIN ADMINISTRATION PROCEDURE (CONT.)
PROCEDURE
• Confirm doctor's order (insulin card/book).
• Wash and dry hands.
• Assemble equipment and ensure validity.
• Explain the procedure to the patient
• Calculate the dose .
• Before drawing up the insulin, gently “roll” the bottle between the
palms to mix and warm the solution.
• Clean the vial with alcohol and keep to dry.
• Remove the cap of the needle and aspirate the same amount of
medicine air.

17. • Inject the air in the vial then Withdraw the insulin .
• Eliminate all air bubbles from the syringe.
• Recap the syringe and keep in the tray with dry Cotton ball and
alcohol swab
• Cleanse the skin with alcohol and allow drying. This helps avoid
pitting of the skin.
• Hold the tissues in a cushion fashion and inject in 90 ° angle
according to the muscle( for thin children and infants 45 °
angle)
INSULIN ADMINISTRATION PROCEDURE (CONT.)

18. INSULIN ADMINISTRATION PROCEDURE
(CONT.)
• Withdraw the piston to exclude that the needle is not in blood vessel. If there
is blood remove the needle immediately and prepare another injection ,if no
blood appears inject Insulin slowly and withdraw the needle quickly.
• Dry the skin surface without rubbing, if needed.
• Make the patient comfortable.
• Observe any untoward actions.
• Discard waste
• Clean and replace reusable equipment.
• Wash and dry hands
• Document necessary information .

19. If mixing two types of insulin :
• Inject the air corresponding to the dosage of cloudy insulin vial
(maintain needle in vertical way not to touch the cloudy
insulin ,not to contaminate clear insulin ) then insert air in clear
insulin vial.
• According to the dose clear / short acting insulin to be
withdrawn first and the cloudy insulin to be drawn in the
syringe.
MIXING 2 TYPES OF INSULIN INTO A SYRINGE

20. MIXING 2 TYPES OF INSULIN INTO A SYRINGE
30 units Air
injected 12 units Air
injected
12 units
insulin
withdrawn
30 units NPH
insulin
withdrawn

21. NURSES' RESPONSIBILITIES AFTER THE INJECTION
Document Document necessary information
Wash and dry Wash and dry hands
Clean and
replace
Clean and replace reusable items
Discard Discard waste (sharp items into the sharp box)
Check Always check to see whether the patient is and has been eating
his normal diet.
Observe Observe the patient for signs of hypoglycemia.

22. SIDE EFFECTS OF INSULIN
• Hypoglycemia
• Allergic reactions
• Local redness, itching – self-limiting,
Disappears with continuation of therapy
• Systemic allergy – angioedema, Anaphylaxis;
rare
• Insulin lipoatrophy
• Insulin lipohypertrophy
• Insulin edema & weight gain

23. CONTRAINDICATION OF INSULIN THERAPY
 Low blood sugar
 Low amount of potassium in
the blood
 Liver problems
 Kidney disease with
reduction in kidney function
 Allergies

24. CONCLUSION
Insulin therapy replaces the insulin in the body would
normally make. People with type 1 diabetes must take insulin
every day. People with type 2 diabetes need to take insulin
when other treatments and medicines fail to control blood sugar
levels.