Week 2 Blog #1

Week 2 January 11-17
Friday, January 15, 2016 
4p-8p 4 Hours Interned


Objective #1:
1. Will demonstrate proper technique and knowledge of possible anatomical sites to use for the          administration of insulin

Probably should explain why insulin is important and give some background about it before spitting out the steps to insulin administration. I would want to know what I am administering and why before doing it! If not, people would be giving out random drugs for no apparent reason! Will be explaining some insulin deficient disease (Type 1 Diabetes and Type 2 Diabetes), some terminology associated with these diseases, the needles used to administer insulin, and the anatomical sites where we allowed to administer insulin and why.

Insulin is a hormone made in the body by beta cells found in the pancreas. It's main function is to use ingested glucose (sugar) as energy or store it for later use. All cells of the body need energy and get this energy from glucose. But glucose can not go directly into the cell. This is where insulin comes into play! When there is an increase in one's blood sugar levels, insulin is released from the pancreas into the bloodstream and attaches to cells. This signals the cells to absorb the sugar from the blood stream and can be used for energy. If there is too much sugar in the bloodstream, insulin will store the excess glucose in the liver and release it when your blood sugar is low and you need more energy. Moral of story, insulin helps your body maintain its blood sugar levels. This little dude is kind of important :)

So what happens when we don't have insulin? A person can become hyperglycemic or hypoglycemic. Hyperglycemia is when an individual has too much sugar in their blood stream. And hypoglycemia is when an individual has too little sugar in their blood stream. There are two circumstances when someone will need insulin. Type 1 diabetes and Type 2 diabetes.
Type 1 Diabetes - This group of individuals are not able to make insulin because the beta cells of their pancreas are damage or destroyed.
Type 2 Diabetes - This group if individuals' cells are resistant to insulin.
So what do we do for these people? The people with Type 1 Diabetes have to have insulin injections to help their bodies process glucose and prevent hyperglycemia. The people with type 2 diabetes pancreas still produces insulin, but the cells are resistant to insulin, thus, are inefficient at regulating glucose AND the other cells for storage are inefficient at absorbing glucose.

In essence, insulin is a very important hormone that is needed in the body. If an individual has either Type 1 Diabetes or Type 2 Diabetes they will need to have insulin administered to maintain proper levels of sugar in their blood stream to prevent hyperglycemia or hypoglycemia. There are different types of insulin such as rapid, slow, intermediate, and long acting insulins. The following is a description of their functions:

• Rapid-acting insulin: It starts working approximately 15 minutes after injection and peaks at approximately 1 hour but continues to work for two to four hours. This is usually taken before a meal and in addition to a long-acting insulin.
• Short-acting insulin: It starts working approximately 30 minutes after injection and peaks at approximately 2 to 3 hours but will continue to work for three to six hours. It is usually given before a meal and in addition to a long-acting insulin.
• Intermediate-acting insulin: It starts working approximately 2 to 4 hours after injection and peaks approximately 4 to 12 hours later and continues to work for 12-18 hours. It is usually taken twice a day and in addition to a rapid- or short-acting insulin. 
• Long-acting insulin: It starts working after several hours after injection and works for approximately 24 hours. If necessary, it is often used in combination with rapid- or short-acting insulin.

Info obtained from http://www.endocrineweb.com/conditions/type-1-diabetes/what-insulin 

Insulin needs to be administered in particular sites due to its absorption rate. It needs to be injected into subcutaneous tissue (the irregular connective tissue right under the skin containing primarily fat cells). The most common sites of the injection of insulin are the posterior part of the upper arm, anterior and lateral part of the thigh, buttocks, and abdomen (two inch radius from navel). The abdomen is the fastest absorbing site. You also have to rotate sites.

Insulin is also measured in a special type of measurement. It is measure in units and not mL or grams like other medications. Because of this and the desired tissue level insulin has to be administered to, insulin injections are given with a particular type of syringe made to measure units, of a certain length, and thickness (gauge). 

Possible syringes to use for the administration of insulin are:

Syringes come in different sizes based on the amount of units desired to administer:
• Each line on a 100-unit syringe marks 2 units of insulin. 
• Each line on a 50-unit or 30-unit syringe marks 1 unit of insulin.
• Use a 30-unit syringe if you take 30 units of insulin or less. 
• Use a 50-unit syringe if you take 50 units of insulin or less. 
• Use a syringe that shows 1/2-unit marks if you need 1/2 a unit of insulin.

The needles come in different lengths and thickness. Side note, the thinner the needle, the higher its gauge. Seems backwards but I didn't design them! For example, a 31-gauge needle is thinner than a 28-gauge needle. And has to be one of the following:
• The standard needle is 1/2-inch long. 
• Needles also come in 5/16-inch and 3/16-inch lengths. 
• The 3/16-inch length is often used for children
• A gauge between 28-31.

Info obtained from http://clinicians.org/images/upload/Insulin_Handout_3.pdf