Insulin Delivery 101 – Injections

Insulin Injection
Standard Insulin Syringe

Being a diabetic creates a life that a follows different sets of rules than non-diabetics. Management of blood glucose is an everyday event that can lead to catastrophic and even deadly outcomes if not properly addressed. Insulin is the hormone that helps the body use or store the blood glucose it gets from food. There are different types of systems for insulin delivery with each one having its own advantages and disadvantages. It’s important to determine the option that is most suitable for specific lifestyles.

Needle and Syringe

The most common form of insulin delivery for diabetics is by injection using either a needle and syringe or an insulin pen. Insulin injection also requires less education and training than the use of an insulin pump.

The most common and affordable insulin delivery is in the form of direct subcutaneous injections using a needle and syringe. The greatest benefit of this delivery system is the cost savings and the fact that insurances will provide coverage compared to other delivery systems like an insulin pen or pump.

The biggest difficulty however is that insulin delivery via needle and syringe is a very involved process taking multiple steps. It is also performed manually which can lead to possible errors; it’s up to the patient to make sure the proper dose is given.

Insulin Pens

Insulin Pens

Insulin pens have become more popular around the world with 95% of insulin-treated patients in Europe, Asia, Australia, and Scandinavia using pens. There are two different types of pen systems: durable and prefilled.

A durable pen has an insulin cartridge that can be replaced. Once the insulin cartridge is empty, the cartridge is disposed of and replaced with a new one. Prefilled insulin pens are also known as disposable insulin pens because they can be thrown away after use. The pen is prefilled with insulin and once the cartridge becomes empty, the entire system including pen and cartridge is discarded.

Insulin pens are very easy to use and one of the big advantages for using them is its ability to adjust the amount of units needed. Insulin pens feature an adjustable knob or dial – at the end of the pen opposite the needle – that can be calibrated to deliver variable units of insulin. Other advantages of insulin pens are the convenience of transportation, compared to a traditional vial and syringe. Insulin pens also provide more accurate dosages and are easier to use for patients that have motor skills or visual impairments.

Although they are easy to use and convenient to transport, insulin pens are usually more expensive than the traditional vial and syringe method and insurance coverage for insulin pens vary widely in the United States. It is also not possible to mix two different types of insulin (short acting and long acting) with a pen.

Injection of insulin via needle and syringe or by pen is the most common insulin delivery system and both take little education compared to more complicated delivery systems like an insulin pump. In the next segment, the discussion will be in regards to delivery of insulin using a pump.

See Clearly with Diabetes!

Diabetic Vision Loss
Seeing is believing and yesterday, I took for granted how lucky I am to have my sense of sight. I tried to put in my contacts yesterday and as soon as my they got close to touching my eyes, a burning sensation occurred – like soap in your eyes – that caused immense pain. I thought I had gotten soap on my contacts or some sort of residue on the lens; I tried at least five different pairs (I wear daily disposables from Acuvue) but it was the same result each time.

I ended up going to the local optometrist at Costco for a checkup and I explained my situation. After examination, she informed me that my eyes were indeed dry and I also had allergens on my pupil which was causing the burning sensation when putting on my contacts. She told me to use lubricating eye drops and just deal with the pain because it would go away once the contacts are in place.

From this experience in itself, I realized how lucky I am to be able to see and I wanted to point out the related dangers between having diabetes and the loss of vision. When diabetes is not being properly managed and blood glucose levels are out of control, complications to the eye can occur resulting in loss of vision and even blindness. In fact Dr. Gary Rankin who is an ophthalmologist at the Retina and Diabetic Eye Center explains that 80% of diabetics (type 1 and 2) will develop retinopathy – acute damage to the retina of the eye caused by damage of its blood vessels – within ten to fifteen years of being diagnosed with diabetes.

The three most common forms of eye diseases caused by diabetes are listed below:

Diabetic macular edema (DME) which is the build-up of fluid in the macula – the part of the retina controlling the most detailed vision abilities -due to leaking blood vessels.

Vitreous hemorrhage occurs when blood vessels in the retina leak into the vitreous space of the eye, which is filled with clear gel in the space between the lens and the retina.

Retinal detachment is the result of abnormal blood vessels stimulating the growth of scar tissue. Complete detachment of the retina to the back of the eye can occur resulting in vision loss.

Anatomy of the Eye
If you have diabetes, it’s highly recommended that you see an eye care professional such as an optometrist or ophthalmologist at least once a year and opt in for the dilated eye exam, which allows the eye care professional to look in the pupil to see inside of the eye more easily and determine if there is any damage to the retina.

Losing your vision may seem scary but diabetic retinopathy can be easily managed. The best way to prevent loss of vision by diabetes is to keep blood glucose levels in control. Keeping A1C levels under control at 7.0 or less is extremely important as it helps to reduce the risk of developing diabetic retinopathy. In fact the American Diabetes Association says that even if retinopathy develops, patients with tight control of their blood sugar tend to have mild, non-sight threatening retinopathy.

I can only imagine how difficult the experience of losing your sight must be. Being a diabetic creates a lot of “what if” thoughts but luckily, those what if’s can be controlled by smart and healthy choices. Remember to always keep blood glucose levels in check, eat healthy, exercise, and be grateful for the blessings bestowed upon us.