Hello to all student nurses
In an earlier post, we find out what is the role of insulin in our body. With the increased incidents of diabetes, the need for insulin builds up. Earlier sole source of insulin was animal origins. By 1980’s production of human insulin by recombinant DNA technology gained popularity and now either human insulin or analogs of human insulin is used in the treatment of Type 1 and Type 2 Diabetes Mellitus. ( with analogs, the insulin molecular structure is modified slightly to alter the pharmacokinetic properties of insulin).
SQ administered insulin is absorbed directly into the bloodstream. Its absorption is affected by some factors as, the exercise of the injected area, local massage, temperature, site of injection ( faster absorption from the abdomen ) lipohypertrophy, jet injectors etc.
Kidneys and liver account for the majority of insulin gradation. But, the major role is taken by the kidneys. So its administration in patients with renal dysfunction should be done cautiously.
Pharmacodynamics of insulin or it’s metabolic effects (onset, peak, and duration of action) vary among insulin preparations. According to this, the available insulins are categorized as Rapid-acting, Short-acting, Intermediate-acting, and Long-acting.
The following table shows the details of the pharmacodynamics of the various insulins.
STORAGE OF INSULIN – POINTS TO KEEP IN MIND
- unopened vials or pens can be stored at 36- 46 f(2-8c)
- insulin should never be frozen, or kept in direct sunlight, or stored in an ambient temperature> 86F(30C)
- vials, cartridges, or pens can be kept at room temperature for 1 month
- loaded insulin is to be used within 2 weeks or to be discarded
- clear insulin if became cloudy to be discarded.
NURSES IMPLICATION FOR ADMINISTRATION OF INSULIN
- Give correct dose and the correct type of insulin. Double check the prescription before administration.
- Use correct syringe – that is calibrated in units.
- Invert the vial several times to mix before the insulin is withdrawn. ” Avoid vigorous shaking”
- Rotate site of administration to prevent tissue necrosis.
- Be sure patient took his normal diet. ( Take special care with patients with vomiting, patients in NPO status )
- While mixing use the mnemonic – clear before cloudy.
- Assist the patient in self-administration of insulin.
- Apply pressure at the site for 1 minute, don’t massage since it may interfere with the rate of absorption.
Hope you all will keep these points while administering Insulin. Have a safe duty. Please feel free to give your feedback and suggestions.