Medications Insulin. Without Insulin With Treatment of Insulin.

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Medications Insuli n

Transcript of Medications Insulin. Without Insulin With Treatment of Insulin.

Page 1: Medications Insulin. Without Insulin With Treatment of Insulin.

Medications

Insulin

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Without Insulin

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With Treatment of Insulin

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Insulin Molecule

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History of Insulin

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Insulin Syringes

• Sterilized before each use

• Needles needed to be sharpened

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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?…

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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?…

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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

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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

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Vocabulary

• Basal Insulin:– Sometimes called “background”

insulin– The insulin that is working steadily

throughout the day

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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

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Insulin'sClassified by action - onset, peak and duration:

•Rapid (bolus/meal)

•Short action

•Intermediate

•Long acting (basal)

There are also mixtures

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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

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1-800-DIABETES www.diabetes.org16

Insulin Types• Rapid-acting - Humalog ®, Novolog ®,

Apidra• Short-acting - Regular• Intermediate - NPH• Long-acting - Glargine (Lantus), Detemir

(Levemir)

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1-800-DIABETES www.diabetes.org17

B’fast Lunch Dinner Snack

Basal and Bolus Insulin

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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

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Insulin Delivery Methods

• Insulin Syringe• Insulin Pen• Insulin Pump or Pod• Jet Injector

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Insulin Syringes

• U-30• U-50• U-100 • One time one

person use only!

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Insulin Pens

CDC just sent an Alert: PENS are one person specific in use

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Types of Pens

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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

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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

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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

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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

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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

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Polycystic Ovary Syndrome (PCOS)

• Ovulation Abnormality

• Metformin can normalize the abnormality thus higher risk for unplanned pregnancy

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Vital Components

• Student and parent education• Family support

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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