1. KBN 2014 Insulin Administration

2. With Out Insulin KBN 2014

3. With Treatment of Insulin KBN 2014

4. If the sugar stays 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 ?

5. KBN 2014 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?

6. Insulin in Schools Today Most students with diabetes take insulin at school O Insulin dosing is specific to individual students and dosing changes may occur O Student’s need for assistance will vary as the student progresses in self- management O Insulin dosing and timing will be specified by the treating health care provider/DMMP O The DMMP includes provisions for modifying the insulin dose KBN 2014

7. Definitions Basal Insulin: O Sometimes called “background” insulin O The insulin that is working steadily throughout the day O Like using the cruise control on a car to keep the speed steady. KBN 2014

8. Definitions Bolus Insulin O A single dose of insulin, given for one of two reasons O Carb/Meal/Snack Bolus: amount of insulin which is given when food is eaten O Correction Bolus: amount of insulin which is given when blood glucose level is too high and needs to be corrected/made lower O Like stepping on the accelerator to give it more gas KBN 2014

9. Basal and Bolus Insulin KBN 2014

10. Types of Insulin Long-Acting O Glargine (Lantus) O Detemir (Levemir) Rapid-Acting O Lispro (Humalog) O Aspart (NovoLog) O Glulisine (Apidra) Short-Acting O Regular (R) Intermediate-Acting O NPH O NPL

11. KBN 2014 Rapid Acting O Insulin Glulisine--Apidra O Insulin Lispro—Humalog O Insulin Aspart—Novolog

12. O Starts working immediately O Strongest effect 30-90 minutes after delivery O Keeps working 3-4 hours Rapid Acting Lispro (Humalog), Aspart (NovoLog), Glulisine (Apidra) KBN 2014

13. Short-Acting Regular (R) O Starts working 30-60 minutes after injection O Has strongest effect 2-3 hours after injection O Keeps working for 3-6 hours O KBN 2014

14. Long-Acting Glargine (Lantus) / Detemir (Levemir ) O Slower absorption and with no pronounced peak

15. KBN 2014 GO TO THE AMERICAN DIABETES ASSOCIATION SAFE AT SCHOOLS VIDEO CHAPTER 7 INSULIN INSULIN BASICS on the internet at YOU TUBE: http://www.youtube.com/watch?v=- FlavJim_NI&feature=share&list=EC3DE9DDE8EB2A2E56

16. Insulin Syringes O U-30 O U-50 O U-100 O One time, one person use only! KBN 2014

17. Where to Give Insulin: On Target! KBN 2014 O Inject into fat layer under skin O Rotate sites O Student should choose site O Common sites: abdomen, thigh buttocks, upper arms Diabetes.org Safe at Schools

18. Injection Sites O Each area absorbs insulin at different rates. O Avoid injecting around belly button, in skin that is scarred, or in skin that has visible blood vessels. O Move at least 1 inch from the last place given. O Exercise can effect the rate of absorption. KBN 2014

19. Insulin Injection Technique KBN 2014

20. Needle size does matter… KBN 2014

21. Giving an Insulin Injection with a Syringe

22. KBN 2014 Giving an Insulin Injection with a Syringe

23. KBN 2014 GO TO THE AMERICAN DIABETES ASSOCIATION SAFE AT SCHOOLS VIDEO CHAPTER 8 INSULIN BY SYRINGE AND VIAL on the internet at YOU TUBE: http://www.youtube.com/watch?v=IfWiEqnVJYo&list=PL3DE9D DE8EB2A2E56&index=9

24. Insulin Delivery Devices O Syringe O Pump O Pen Device KBN 2014

25. Insulin Pumps/Pods KBN 2014

26. Insulin Delivery O External insulin pumps connect to narrow, flexible plastic tubing that ends with a needle inserted just under the skin O The insulin pump delivers both basal and bolus doses of insulin http://www.childrenwithdiabetes.com

27. KBN 2014 Insulin Delivery O An insulin pen is a device that looks like a pen with a cartridge. http://www.childrenwithdiabetes.com

28. Insulin Pens O Techniques for dosing and insulin delivery are similar for both types of pen devices:  Prefilled pens  Reusable (cartridge) pens O Both long-acting or basal insulin and rapid-acting or bolus insulin are available in pens O Most students will only take rapid-acting or bolus insulin in school KBN 2014

29. Insulin Pen: Preparation 1. Gather supplies. Verify insulin type O open device (with cartridge) O pen needle 2. Have student choose injection site 3. Clean injection site 4. Screw needle onto pen KBN 2014

30. 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 ordered in DMMP KBN 2014

31. Insulin Pen: Injecting 8. Administer the injection 9. Push down on the plunger 10. Count to “5” remove needle from tissue 11. Remove and dispose of pen needle 12. Complete the needed documentation KBN 2014

32. Insulin Pens KBN 2014 PENS are one person specific in use

33. KBN 2014 GO TO THE AMERICAN DIABETES ASSOCIATION SAFE AT SCHOOLS VIDEO CHAPTER 9 INSULIN BY PEN on the internet at YOU TUBE: http://www.youtube.com/watch?v=D9Qa5J35ZPo&index=10&list =PL3DE9DDE8EB2A2E56

34. Insulin Care Guidelines O Do not use insulin past the expiration date. O Ask the school nurse regarding storage of insulin O Don’t expose insulin to extreme temperatures (Hot or Cold) KBN 2014

35. Insulin Care Guidelines O Allow insulin you are injecting to come to room temperature before administering O Always look at your insulin for particles or unusual color. If it looks different than normal, don’t use it! KBN 2014