Insulin pen cartridge, "shake" before use
With the increase of the prevalence of type 2 diabetes, more and more patients are using insulin pens to inject themselves at home. A large number of patients with type 2 diabetes do not know that certain insulin they use needs to be mixed. In addition, other issues derived from it are also worthy of attention. Now, let's have a look.
Question 1: What are the consequences of insulin that needs to be mixed?
For insulin that needs to be mixed before injection, subcutaneous injection without mixing may lead to poor blood glucose control and even increase the risk of hypoglycemia. These problems are manifested in the level of blood sugar: blood sugar is high and low, like riding a roller coaster. The risk of unstable blood glucose is very high for patients with cardiovascular and cerebrovascular diseases.
Question 2: Which insulin needs to be mixed?
For this type of insulin, we can judge from the appearance, name and instructions.
1. Appearance
Generally speaking, all the insulin with white cloud like suspensions need to be mixed well before use, because this kind of insulin will delaminate after being left alone, with the upper layer of transparent colorless liquid and the lower layer of white cloud like liquid.
In addition, the insulin pen cartridges that need to be mixed will have varying numbers of small round glass beads. The existence of these small glass beads can help the liquid in the cartridge to reach a uniform state in the process of mixing faster. We can understand it as "the stirring rod used for drinking coffee".
2. Name
All insulin with "premixed", "mixed" and "30/50/70" in their names are insulin mixtures of two different components, which need to be mixed well before use. All insulin with the word "protamine" in its name contains protamine, that is, "NPH". Such insulin also needs to be mixed before use.
3. Instructions
If the above two methods cannot help you make a judgment, you can use the most straightforward and direct method: carefully read the instructions of the insulin pen cartridge. The insulin to be mixed will be clearly described in the column [Usage and Dosage], and the mixing method will be described.
Question 3: How to mix insulin correctly?
Here, the pharmacist introduced the most effective general mixing method found in evidence-based research. Common insulin that needs to be mixed in the market can be mixed with this method.
1. Preparation before mixing
The insulin pen cartridge bottle used for the first time needs to be taken out from the cold storage (2~8 ℃) environment in advance, placed at room temperature (15~30 ℃), and then mixed. If you want to quickly warm up the liquid in the cartridge, you can place the cartridge between your hands and roll it slowly to speed up the temperature recovery. The insulin pen cartridge being used at room temperature can be directly mixed in the insulin pen according to the following methods, without taking it out of the pen.
2. Mixing operation method
First, roll the insulin pen cartridge horizontally with both hands for 10 times, and complete it within 5 seconds; Then, turn the insulin pen cartridge bottle 180 ° for 10 times within 10 seconds, so that the ball in the cartridge bottle rolls back and forth in the tube with the action.
It should be noted that the two groups of movements should be guaranteed to reach the above duration and should not be shaken rapidly and violently. This is because: violent shaking will cause bubbles in the liquid, reducing the accuracy of drug administration; At the same time, severe shock may lead to insulin failure. In addition, after each rolling and turning, the insulin suspension shall be checked with naked eyes to confirm whether it is fully mixed: the fully mixed insulin shall be in a uniform white cloud. If it is still uneven, repeat the above two steps.
After the above operations are repeated twice, if there are still lumps, frost like white solids, particles and other substances in the cartridge, this insulin may have become denatured and invalid, so this cartridge should be abandoned and should not be used any more.