medications insulin. without insulin with treatment of insulin
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Medications
Insulin
Without Insulin
With Treatment of Insulin
Insulin Molecule
History of Insulin
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Insulin Syringes
• Sterilized before each use
• Needles needed to be sharpened
KDPCP (Kentucky Diabetes Prevention and Control Program) 2011
Insulin is like a key that opens up the door and
allows the sugar to get out of the blood and inside the
cell where the cell can “burn” the fuel for energy!
Why is Insulin So Important?…
KDPCP (Kentucky Diabetes Prevention and Control Program) 2011
If the sugar stayed in your blood – it doesn’t do your cells (body) any good.
The sugar has to get inside the cells for the body to use it.
Why is Insulin So Important?…
Insulin in Schools Today • Most student need to take insulin in school• Insulin dosing varies from student to
student and change over time• Student's needs for assistance will vary as
the student progresses in self- management
• Insulin dosing and timing will be specified by the treating physician – May include provisions for the parent/student
who are capable to modify dosing
Vocabulary• Target Range:– A range of numbers that
represents and individual’s ideal blood glucose level
– Determined by health care team with the individual child and their family
Vocabulary
• Basal Insulin:– Sometimes called “background”
insulin– The insulin that is working steadily
throughout the day
Vocabulary
• Bolus Insulin– A single does of insulin, given for
one of two reasons• Carb/Meal/Snack Bolus: insulin dosed
when food is eaten• Correction Bolus: insulin dosed when
blood glucose level is too high and needs to be corrected/made lower
Insulin'sClassified by action - onset, peak and duration:
•Rapid (bolus/meal)
•Short action
•Intermediate
•Long acting (basal)
There are also mixtures
Insulin Action Times
Type of Insulin Generic/Trade Name
Time of Onset Peak Action When the insulin has the strongest
effect
Hours of DurationHow long the insulin usually
lasts
Rapid-Acting lispro (Humalog®)aspart (Novolog®)glulisine (Apidra®)
5-15 minutes 30-90 minutes < 5 hours
Short-Acting Regular(Humulin R ®, Novolin R®)
30-62 minutes 2-3 hours 5-8 hours
Intermediate-Acting
NPH (Humulin N ®, Novolin N ®)
2-4 hours 4-10 hours 10-16 hours
Long Acting(Basel Insulin)
Glargine (Lantus ®)Detemir (Levemire®)
2-4 hours3-8 hours
No Peak Up to 24 hours
1-800-DIABETES www.diabetes.org16
Insulin Types• Rapid-acting - Humalog ®, Novolog ®,
Apidra• Short-acting - Regular• Intermediate - NPH• Long-acting - Glargine (Lantus), Detemir
(Levemir)
1-800-DIABETES www.diabetes.org17
B’fast Lunch Dinner Snack
Basal and Bolus Insulin
1-800-DIABETES www.diabetes.org18
Where to Give Insulin: On Target!
• Inject into fat layer under skin• Rotate sites• Student should choose site
• Common sites: abdomen, thigh buttocks, upper arms
Insulin Delivery Methods
• Insulin Syringe• Insulin Pen• Insulin Pump or Pod• Jet Injector
Insulin Syringes
• U-30• U-50• U-100 • One time one
person use only!
Insulin Pens
CDC just sent an Alert: PENS are one person specific in use
Types of Pens
1-800-DIABETES www.diabetes.org24
Insulin Pens• Techniques for dosing and insulin delivery are
similar for both types of pen devices: ─ Prefilled pens
─ Reusable (cartridge) pens
• Both long-acting or basal insulin and rapid-acting or bolus insulin are available in pens
• Most students will only take rapid-acting or bolus insulin in school
1-800-DIABETES www.diabetes.org
Insulin Pen: Preparation
1. Gather supplies. Verify insulin type─ pen device (with cartridge)─ pen needle
2. Have student chose injection site
3. Clean injection site
4. Screw on pen needle
1-800-DIABETES www.diabetes.org
Insulin Pen: Dosing
5. Prime: Dial “2” units. If the pen is being used for the first time, prime 4-6 units as per manufacturer’s instruction
6. Hold upright. Remove air by pressing the plunger. Repeat “Prime” if no insulin shows at end of needle
7. Dial number of units to be administered as per Health Care Plan
1-800-DIABETES www.diabetes.org
Insulin Pen: Injecting
8. Administer the injection9. Push down on the plunger10. Count to “5”
11. Remove and dispose of pen needle
12. Complete the needed documentation
Oral Medications
• Metformin Approved for use in children
10-16 years of age with type 2Two common side effects
DiarrheaNausea
• Low risk of causing hypoglycemia
Polycystic Ovary Syndrome (PCOS)
• Ovulation Abnormality
• Metformin can normalize the abnormality thus higher risk for unplanned pregnancy
Vital Components
• Student and parent education• Family support
Presentation Resources
ADA Diabetes Care in the School and Day Care Setting, Diabetes Care, January 2012
The Art and Science of Diabetes Self-Management Education Desk Reference, 2011
KY Diabetes Prevention and Control Program, Diabetes Basics Presentation, 2011
KY Diabetes Prevention and Control Staff National Association of School Nurses
KDPCP (Kentucky Diabetes Prevention and Control Program) 2011
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