Insulin is administered by subcutaneous injection, usually using a pen or a continuous infusion insulin pump.
The type of insulin administered to diabetic children and adults is the same: a slow-acting insulin to mimic the continuous pancreatic insulin release that occurs (in general, the glargine and detemir analogs), and a fast-acting insulin to metabolize the blood glucose that rises after each meal (the analogs: lispro, apidra and aspart), always trying to mimic the normal pancreatic secretion of the healthy individual.
Insulin administration
Insulin pens (slow and rapid) are usually used for subcutaneous injections. Slow insulin is administered in one or several daily injections and rapid insulin before each meal. Therefore, each patient has to take a minimum of 4 injections per day: one slow injection and 3 fast injections (before breakfast, lunch and dinner). But it is very common for them to have to increase the number of daily injections to be administered. Only rapid-acting insulins are used in infusion pumps. The insulin passes through a small catheter inserted under the skin, which must be changed every three days (maximum four), so patients on infusion pumps are only injected every three or four days.
Insulin adjustment is carried out taking into account the blood glucose level control performed by the patient with a glucometer. They should be checked 6 times a day: before and two hours after meals and, on many occasions, also at 3 o’clock in the morning. The control before each meal is crucial to define the amount of insulin to be injected, since it must be adapted to the figure obtained. It is also necessary to know how to count the carbohydrates to be ingested (also taking into account the proteins and fats contained in the meal), as well as the exercise to be performed or that have been performed, so that the insulin dosage is as accurate as possible according to the needs of the moment.
Thus, these patients require exhaustive knowledge that they only acquire progressively through continuous and demanding diabetological education.