Fruit of a bibliographic review and a job of 127 professionals, sponsored by the BD brand (needles), some of the recommendations related to insulin injections have been modified.
The study revolves around the prevention of intramuscular injections, causing hypoglycemia.
As a curiosity: the first diabetic to be punctured insulin was called Leonard Thompson;Banting and Best Discoverers of insulin, first tested with a dog that the pancreas were removed and when they found that the experiment worked, Leonard Thompson was injected insulin with a 40 mm needle: shock :: Shock:
Before such a puncture:-/ then they passed to an 18 mm.
The old practitioners, punctuated insulin at home, carried an grinding machine to sharpen the needle ... used it for each patient, after boiling it.
The needle reuse rate currently in our country is 4. that is, each patient reuses each needle an average of 4 times: shock :: Shock :: twisted :: twisted:
Current studies show that there is only a distance of 2 mm until reaching the subcutaneous area so 4 mm needles are enough for most people.A greater needle size more probability of intramuscular injection.
It is curious to see how the thickness of the skin of a newborn (up to 1 year) is equal to that of a 12 or 13 -year -old child.Between the first and 12/13 years there is less space in the subcutaneous zone and the muscles are much closer to the epidermis, therefore the danger of intramuscular injections is much greater.
Growth things.
Long needle and technique recommendations according to patient group:
- Needle length: 4mm, 5 mm, 6mm and 8mm syringe for all people, including obese people.With pinch on thighs and arms for thin people and children;along with an angle of 45 degrees on thighs and arms.
- Injections in adults can be 90 degrees (straight angle with the skin) with needles of 4.5 and 6 mm ... without the need for pinch.
- Pellizco mandatory if 8 mm needles and 45 degree angle are used
- There is no evidence that needles of size greater than 8 mm are more effective for insulin injection.
As you can see, the 12 mm needles will disappear and the 4 mm will be marketed soon.
Insulins and injection areas
Ultra -grapid insulins (Novorapid, Humalog, Apidra), Slow insulins (Lantus, Levemir) and LPG1 (Exenetide, Byetta, Victoza, Liraglutide) can be injected into any injection zone, absorption speed does not vary depending on the area ...It the same arms, legs, abdomen ... much more influential is to prick in areas where they do not have lipodystrophies.
Human insulins (NPH, Actrapid, Insulatard, Humulin, Mixtard) are more sensitive to absorption according to the injection zone.If used as basal they should be used in thighs and buttocks to slow the absorption.
If the dose of insulin to be injected is high (greater than 40 insulin units) should be done in 2 doses.It doesn't matter the type of insulin as it is.When doses greater than 40 units are injected there is a danger of overflow, let's say that the skin is not able to store more than 40 units and overflows (even overflowing insulin).
In these cases it is advisable to distribute the dose in 2 punctures of 20.