- Do not miss the insulin doses:
Insulin is an inevitable treatment in a child with type 1 diabetes mellitus as the body’s pancreas no longer produces enough insulin required to burn the fuel and produce energy.
When insulin doses are skipped, there may be a chronic deficiency of insulin in the body that may lead to complications viz.
- Sustained high blood sugar levels that lead to long term complications like kidney, nerve, eye injury.
- Acute decompensation leading to a potentially fatal condition called Diabetic ketoacidosis.
It is highly appreciable if your child injects his/her insulin by self, BUT do not just ASK if the dose is taken, WATCH that each dose is taken.
2. While you purchase the insulin:
- Various brands of the different insulins are available. Always have a look if the shopkeeper has sold you the one you asked for.
- How many of us actually have a look at the expiry date of medicines like paracetamol when we purchase them?
- Make it a habit to check the insulin for their expiration dates.
- Make sure that the insulin provided to you was stored in the proper conditions so that you don’t get the spoiled lot.
- Always replace the stock well before the last few drops are remaining.
3. Never freeze the insulin injections:
Insulin is available in vials as well as cartridges for use with devices called insulin pens. Either of them requires proper storage at 2-8 degree Celsius. This can be ensured by storing the insulin in the lower compartment of the refrigerator.
Those who cannot afford a refrigerator should store the insulin in cool damp places inside an earthen pot.
4. Carry your insulin safely:
Storing at the proper temperature is not only essential at home, but also while the insulin is being carried during the journey.
Thermocol boxes with ice packs or thermos flask with ice cubes or ice-cold water must be used during transport.
5. Use the right syringe that matches the insulin strength:
Insulin vials are available in strengths of 40 U/ml or 100 U/ml and cartridges are available as 100 U/ml.
Appropriate syringes must be used when drawing and injecting the insulin i.e. 40 U syringe with a 40 U/ml vial and 100 U syringe with a 100 U/ml vial or cartridge.
Any interchange in the syringes will lead to erroneous dosing that will lead to complications.
6. Closely look at those syringes:
Each mark/line on the 40 U syringe signifies 1 unit while on the 100 U syringe, each mark signifies 2 units.
One must be aware of this difference and ensure proper dosing while using the 100 U syringe. Lately a 50 U/0.5 ml syringe is becoming available.
7. Practise site rotation for insulin injections:
Insulin is injected into the outer aspects of the arm, thigh, abdomen, and buttocks.
Within these areas, it is obligatory to keep changing the sites where insulin is being injected. This is necessary to prevent lipodystrophy or hardening under the skin, which results if insulin is repeatedly injected at the same site.
Impaired absorption of insulin from these sites leads to erratic levels of blood glucose.
8. Priming is essential for those using insulin pens:
While using the insulin pen, one must always make sure that the pen is ready to use or in other words, the pen should be primed before actually using it for injection of insulin.
This is necessary to ensure that the pen is in a working state and also to get rid of any air bubbles within the cartridge.
Your doctor or diabetes educator will teach you the exact technique of priming.
9. Practise safe disposal of syringes and needles:
Used insulin syringes comprise the biomedical waste that should be disposed of safely like any other medical waste.
Throwing them into general waste poses a risk of a prick to animals and other human beings.
In hospitals, the syringes are disposed of after destroying the needles with the needle cutter/ burner.
At home, collect the syringes in an airtight plastic container and dispose at a nearby hospital at the end of the month.
10. Adjust the insulin doses: Make efforts
Your child makes the effort of checking the blood sugars and taking that prick for the insulin dose. Let this not be a mechanical act.
An additional effort from you to have a check if the insulin doses require any modifications will go a long way in optimizing your child’s blood glucose control.
The insulin doses need adjustment depending upon the premeal blood glucose level of that time and the food consumed.
Apart from these daily adjustments, a review of the sugar charts every few days and dose modification based on the blood glucose readings of the previous few days should be routinely done.
I advise all the members of the family to sit together and figure out the adjustments required on weekly basis. This should also be an opportunity to exchange knowledge and address any issues the child may be facing.
Make efforts to learn and understand from your doctor how these adjustments are made. In the initial few days, do the changes while the doctor oversees you, and subsequently, I am sure you will find yourself capable of making these adjustments on your own.
The better you know about diabetes and insulin, the better you will manage and be able to achieve the targets of blood sugar control. So keep reading, keep gaining knowledge, and keep sharing.
Do not hesitate to leave your queries or comments.