Safely administering your insulin in the most convenient way possible is important. This helps to ensure that you get your doses on time and that the amount of insulin that you are taking is within the prescribed range. Insulin has to be injected, but you have some options and one of these is insulin pen needles. These needles work with a device that looks and functions similar to a pen. For some people, these are easier to use than a traditional needle and syringe for injecting insulin.

WHAT IS A PEN NEEDLE FOR INSULIN?

Pen needles are becoming a more popular way to inject insulin. For some people, this insulin delivery method is easier compared to having to draw up insulin and use a normal needle and syringe to inject the medication. These needles attach to a pen that holds the insulin. The needles themselves are hollow, allowing the insulin to come through them.

There is a plastic hub that the needle is embedded in. The plastic part is what attaches to the pen. They may snap into place or screw on, depending on the pen needle and pen that you are using. Once the needle is attached to the pen, you will follow the instructions for the pen to inject the insulin into your body.

WHO SHOULD CONSIDER A PEN NEEDLE FOR INSULIN?

Unless you need to self-mix your insulin, you can usually use a pen needle to inject insulin. These devices are especially ideal for people who need to inject insulin several times per day. Some people see insulin pens as less scary compared to a normal syringe and needle, making it easier to inject insulin as needed throughout the day. The following are other advantages of using a pen needle for insulin:

• It is easier to carry a pen and pen needle with you when you need to inject insulin away from your home

• Most types of insulin can be injected using these devices

• The dosage is more precise, resulting in less insulin being wasted

• You will not have to draw up your own insulin, allowing for better control over the dosage

• You use a dial on the pen to determine the insulin dosage

WHAT ARE THE SIZES FOR PEN NEEDLES?

Insulin pen needles come in different sizes, allowing you to choose the one that is the easiest for you to use. When determining the right size, you have to consider the gauge and length of the pen needle. Millimeters are used to measure the needle's length. The lengths range from four to 12.7 millimeters, with four millimeters being the shortest needle available. The thickness of the needle is the gauge. The higher the number, the thinner the needle. For example, a needle that is 27 gauge, is thicker than one that is 32 gauge.

DO YOU NEED TO PRIME A PEN NEEDLE FOR INSULIN?

You must prime your pen before you inject your insulin. This ensures that there is no air that will inject with the insulin. When your pen is properly primed, you will get the correct dose of insulin. Air in the needle may cause you to get too much or too little of the medicine, which could negatively affect your blood sugar levels. You should follow the instructions that come with your pen to ensure that you have it primed properly and always prime the needle before every injection.

WHAT ARE THE DIFFERENT TYPES OF INSULIN?

Your doctor may prescribe more than one type of insulin, depending on what controls your blood sugar levels the best. There are five types of injectable insulin. It is important to understand what these are so that you know why your doctor prescribed a specific type of insulin. The five insulin types that are injected include:

• Rapid-acting: They peak in about 30 to 90 minutes, start working in under 15 minutes and the total duration is approximately three to five hours.

• Intermediate-acting: They peak in about eight hours, start working in one to three hours and the total duration is approximately 12 to 16 hours.

• Regular: They peak in about two to four hours, start working in 30 to 60 minutes and have a total duration of three to five hours.

• Long-acting: They have little to no peak, start working in about one hour and have a total duration of approximately 20 to 26 hours.

• Pre-mixed/combination: These are a combination of regular and intermediate insulin. The peak time, start time and duration depend on the exact combination of insulins.

WHEN AND HOW DO YOU INJECT INSULIN USING A PEN NEEDLE?

Pen needles for insulin are used according to the prescription that your doctor provides. Some people need to inject insulin more often than others. In most cases, you will check your blood sugar, and this will determine the dose of insulin that you need to inject. Your doctor will give you a chart and when you get your blood sugar reading, it will tell you what dose you need to inject at that glucose level.

For long-acting insulins, you may inject these on a regular schedule. Then, your doctor will give you a short-acting insulin to help to bring down your blood sugar levels when they get too high. You will use the same technique with a pen needle no matter which type of insulin you are injecting. If the needle is eight millimeters or longer, lift the skin before injecting the insulin. For needles that are six millimeters or shorter, you do not have to lift the skin.

Before you inject your insulin, you should use an alcohol swab to cleanse the injection site and wash your hands with water and soap. Ensure that the needle is properly attached to the pen by following the instructions that come with these items. Determine if you need to lift your skin based on the length of the pen needle for insulin that you are using. Then, use a 90-degree angle to insert the needle into your skin to inject the insulin.

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Diabetes Bag

Living with diabetes can present a variety of challenges. Having your diabetes supplies available at all times makes it easier to maintain your blood sugar levels. A diabetes bag makes it easy to have all of your diabetes accessories and supplies in one convenient place. Learning about the bags that are available and what to put in them helps to ensure that you are always able to manage your diabetes no matter where you are.

WHAT TYPES OF BAGS ARE AVAILABLE?

There are several bag options to carry your diabetes supplies. If you want to carry your supplies hands-free, consider one that is in the style of a backpack or a fanny pack. These should zip up so that none of your supplies fall out when you are moving around. If you carry a handbag, consider one that will fit inside to minimize how many bags you have to carry with you.

You might also consider a hard case, especially if your insulin comes in a glass vial. A hard case will protect the vials against breakage if you accidentally drop it. These usually snap shut so that the contents remain secure. Some hard cases will be divided into different compartments, allowing you to organize your supplies in a way that allows you to access everything quickly.

These bags come in multiple sizes. You should consider the items that you need to take with you. For example, when taking multiple medications for diabetes, you will likely need a larger bag than someone who only needs to carry a vial of insulin and a few syringes. You can set your items out and take some measurements to get a general idea about the best size of bag to hold all of your diabetes supplies.

WHAT SHOULD YOU PUT IN YOUR DIABETES CASE OR BAG?

There are several diabetic accessories that you should include in your compact diabetes case. You want to have all of the items you need to maintain your glucose levels and check them. To start preparing your diabetes case, you should make a list of the essentials so that you do not forget anything. The following items should be put in a supply bag for diabetes:

• Your diabetes medications, including any insulin vials, insulin pens or pills that you are taking

• Alcohol swabs and bandages for when you need to test your blood sugar

• Your glucose meter with test strips and lancets

• Backup batteries for your blood glucose monitor

• A card that includes the type of diabetes you have, the medicines that you take and your doctor's contact information

• Small sugary snacks for times when your blood sugar gets too low

• Needles and syringes if you use insulin

• A small flashlight so that you can see your diabetes kit in the dark

HOW TO PACK A DIABETES BACKPACK

Once you choose a diabetes bag that fits your needs and you have all of your supplies ready, it is time to pack it. You should have enough of your medication to get you through at least 24 hours to be safe and when you are going to be away longer than this, carry enough medication for as long as you will be gone plus two days to give yourself a little extra just in case you get delayed returning home. You should have two lancets and test strips for each test. For example, when you test twice a day, you need four lancets and four test strips per day. This gives you extra just in case you need to repeat a blood sugar test.

Ensure some diversity regarding the foods that you bring with you. For example, bring some fresh fruit, some hard candy and some glucose tablets just in case your blood sugar gets too low. Pack enough alcohol swabs and bandages to cover each blood sugar check that you need to perform. Make sure that your bag has a little extra room so that if you remember something that you need to add at the last minute, your bag will be able to accommodate it.

KEEPING YOUR INSULIN COOL IN YOUR DIABETES TRAVEL CASE

Insulin contains preservatives to keep it fresh and effective. However, if your insulin gets too warm, it will eventually no longer work. After insulin remains in an environment with too high of a temperature for too long, the protein will start to break down as bacteria starts to grow in the liquid. You should keep your insulin at 36 to 46 degrees Fahrenheit to keep it safe to use.

When you are home, keep your insulin vials in your refrigerator. You should not keep it in your diabetes supply bag 24/7. When you are out, you can use cold packs to maintain a safe temperature for your insulin vials. There are bags that are insulated that will help to keep your insulin cool for longer. Also, when you use insulin pens, follow the storage and travel instructions that come with them to keep them safe.

ENSURING THAT YOUR DIABETES TRAVEL BAG MEETS TSA STANDARDS

When you plan to travel by airplane, you need to ensure that your diabetes travel bag meets all TSA standards so that you can carry it on the plane with you. Since your diabetes supplies often include needles and syringes, sharp lancets and prescription drugs, you need to ensure that you are following all TSA regulations or else you might have some trouble when you are trying to board. Use the following as a guide to ensure that your diabetes case passes TSA inspection:

• Insulin: If you take insulin, it is imperative that you have it on the plane with you. Be careful because when you put it in a bag that you check, the temperature and pressure changes in the luggage area on a plane could negatively affect your insulin. The TSA allows you to bring insulin on board even if it exceeds their rule of no liquids over 3.4 ounces. However, the prescription information should be clearly visible so that they know that it is legally prescribed to you. This is especially important for international travel. You are also allowed to bring cold packs to keep your insulin at the proper temperature.

• Glucagon: You should carry this in its pharmaceutically labeled container to get it onto a plane.

• Needles and syringes: You can bring these on a plane, but you need to have the prescription from your doctor with you. It is best to bring the box that these diabetes supplies come in since it will have the pharmaceutical label.

• Lancets: Your lancets should be with your glucose monitor when you fly. They must have the manufacturer label attached and be capped to pass airport security.

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1CC Syringe

If you have diabetes and are insulin dependent, it is important that you have syringes that can accommodate the dosages that you need to inject. The syringes that you use should also be easy to handle and to read so that you can be sure that you are always properly dosing your insulin. If you are getting too much or too little of the medicine, this could have a negative impact on your blood sugar levels. Learning more about a 1cc syringe ensures that you have the knowledge necessary to determine if this is the best syringe size for you.

READING A PLASTIC SYRINGE

When you get your insulin syringes, it is important to look at the markings carefully. Different manufacturers may design their syringes differently, causing the markings to look different. It is important that you can read the markings clearly so that you are drawing up the proper insulin dose each time. If you switch to a different brand, look at a syringe when you are still at the pharmacy so that if you have questions, the pharmacist can help to ensure that you are reading the markings correctly.

One cubic centimeter (cc) equals one milliliter (mL). So, when you draw up one cc of insulin, you are drawing up one mL of insulin. Since insulin is typically measured in units, it is important to know how these numbers translate to units of insulin. When you draw up one unit of insulin, this is equal to 0.1 milliliters. One cc or one mL of insulin is equal to 100 units of insulin.

IS YOUR INSULIN SYRINGE THE RIGHT SIZE?

An insulin syringe that can hold 1cc is ideal for those who need to inject 50 to 100 units of insulin in a single dose. To determine if 1cc is the right size for you, make note of the insulin doses that you inject regularly. If your average dose is 30 to 50 units of insulin, for example, a ½-cc syringe is generally sufficient. However, if you are administering higher doses at least a few times a week, it makes sense to move up to a syringe that holds 1cc because this will result in you needing to do fewer injections.

WHAT IS THE BEST NEEDLE FOR YOUR INSULIN SYRINGES?

A syringe and needle work together to allow you to inject your insulin, so it is imperative that they are compatible. When you are using a 1cc syringe, you have options regarding the best type of needle. There are several factors to consider regarding needles, and once you determine which factors apply to you, it will be much easier to choose a needle and properly inject your insulin

Insulin needles come in varying lengths, with the average being about eight to 12.7 millimeters. Since insulin is meant to be injected into your body's subcutaneous tissue, a needle that is eight millimeters is usually sufficient. However, adults who are larger might need a longer needle to ensure that the insulin gets into the proper area. Your doctor will help you choose a needle length that works best with your body type.

The next factor to consider is the width of the needle which is measured by its gauge. When the gauge measurement is higher, this means that the needle is actually thinner. For example, a 31 gauge is thinner than a 30 gauge. Insulin needles are typically 28 to 31 gauge. This gauge range will work with any syringe that holds 1cc of insulin, so you can choose the gauge that is the most comfortable for you.

HOW TO DRAW INSULIN INTO A SYRINGE

It is imperative that you draw insulin into your syringe properly. By doing this, you are using a safe technique and ensuring that you are getting the full dose of insulin. Proper drawing up of your insulin will also make it easier to ensure that you are pulling the proper dose into the syringe. Follow these steps when you draw up your insulin into your syringe:

• Wash and dry your hands

• Place the insulin vial between your hands and roll it approximately 10 times

• Use an alcohol swab to wipe off the top of the insulin vial

• Attach your syringe and needle if they are not already attached

• Draw air into the syringe that is equal to how much insulin you will draw into the syringe (for example, if you will be injecting 10 units of insulin, draw 10 units of air into the syringe)

• Place the needle into the insulin vial and inject the air

• Turn the vial upside down and carefully draw the proper units of insulin into your syringe

• Withdraw the needle and syringe from the vial

• Inspect the syringe for air bubbles and remove them by flicking the plastic syringe in the area where the bubbles are present

PROPER STEPS TO INJECT YOUR INSULIN USING A NEEDLE AND SYRINGE

Once you have your insulin dose drawn into your diabetes syringe, it is time to inject it. You should not fill your syringe until you are ready to inject. You need to use the proper injection technique to make the process as comfortable as possible. This will also make sure that you are getting the full dose of insulin in the syringe. Use the following steps to inject your insulin:

• Choose a place on your upper arm, side of your thigh or abdomen to inject your insulin

• Avoid areas where you have bruising or a wound

• Use an alcohol swab to clean your skin at the injection site

• Using your index finger and thumb, pinch the injection site gently (use your non-dominant hand for this)

• Hold the needle and syringe straight and insert it into the pinched skin (use your dominant hand to hold the needle and inject your insulin)

• Push the plunger on the syringe to inject the insulin into your body

• Leave the needle in your skin for approximately five seconds

• Withdraw the needle from your skin

• Apply gentle pressure to the injection site for about 10 seconds so that none of the insulin that you just injected will leak out

• Dispose of your syringe and needle properly

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Diabetic Amyotrophy

Approximately one percent of people with diabetes develop diabetic amyotrophy. Also, referred to as proximal diabetic neuropathy, this is a type of peripheral nerve disease. It is a diabetes complication that affects the nerves, mostly affecting the thighs, buttocks, hips and lower legs. The symptoms that occur are the result of damage to these nerves in these areas of the body. While rare, all people with diabetes mellitus should know about diabetic amyotrophy, so that they can tell when it is time to see their doctor.

CAUSES OF THIS TYPE OF DIABETIC NEUROPATHY

The majority of people who develop this condition have Type 2 diabetes and are over age 50. Men develop it more often than women. It is caused by nerve damage that can result from high blood sugar levels. Because of this, people with uncontrolled Type 2 diabetes are at the highest risk for diabetic amyotrophy.

When blood sugar levels remain high over time, this can cause damage to nerves throughout the body. Glucose levels that are high over a prolonged period of time may also cause issues with how the nerves send signals throughout the body. In addition, the capillaries can also experience damage from prolonged high glucose levels. These blood vessels are responsible for sending nutrients and oxygen to the nerves. Without adequate nutrients and oxygen, the nerves eventually become damaged.

POSSIBLE SYMPTOMS

Once symptoms begin, they tend to progress over time. Then, over months or years, they gradually lessen. However, most people will continue to have at least some symptoms to some degree over the long-term. The following are possible symptoms of this type of diabetic neuropathy:

• Sudden pain in the buttocks, hips or thighs that can sometimes be severe

• Losing reflexes in your lower limbs, such as the knee-jerk reflex, when the doctor is testing your reflexes by tapping your knee

• Weight loss that is unintentional

• Leg weakness that can make it hard to stand up when you are seated

• Losing muscle tissue in the affected areas, such as your thighs

In most cases, only one side of the body is affected. However, in rare cases, the condition may start to affect the other side of the body. Those with this condition tend to experience the symptoms in the lower body, from the hips down. The pain is usually one of the first symptoms. It may not be severe enough when it starts to cause alarm, but can become severe over time.

GETTING A DIAGNOSIS

To diagnose diabetic amyotrophy, doctors start with a full medical history that includes evaluating how well your diabetes is managed. Doing an A1c blood test can tell your doctor about the management of your blood sugar levels over approximately three months. If the test and other information indicates that your blood sugar levels have been uncontrolled, this can provide some insight regarding the cause of your pain, weakness and other symptoms.

Two tests that may be ordered include electromyography and nerve conduction studies. Electromyography looks at your muscle health and the health of the nerves that are responsible for controlling them. This test involves strategically inserting thin needles into the affected muscles. The doctor will look at a monitor to get information about your muscle's electrical activity. You may be asked to flex the muscle being tested during the exam.

In most cases, nerve conduction studies are performed during the same visit. This test measures how quickly electrical signals are traveling through a nerve. Instead of thin needles, this test uses patches that are placed over the nerves that are being tested. A monitor provides the doctor with information regarding the speed of the nerve signals so that they can determine if there are abnormalities.

TREATMENT OPTIONS

Treating this condition is the same as treating peripheral neuropathy. There are different medications and therapies that may be helpful. In many cases, your doctor will prescribe more than one treatment to help to control your symptoms. The following medications might be considered:

• Over-the-counter pain medicines may be recommended to reduce your discomfort. To help with pain related to inflammation, medicines like naproxen or ibuprofen might be recommended.

• Antidepressants may help with nerve pain.

• Anti-seizure medicines affect your nerves to reduce associated pain.

• Topical medicines, such as capsaicin cream, might be helpful to reduce pain. In some cases, a lidocaine patch could be used, since it can numb a small area that is especially painful.

Your doctor might also recommend different therapies for this condition. Physical therapy is common, especially if your weakness or pain are moderate to severe. This therapy involves different exercises that can improve your pain, mobility and weakness. In some cases, occupational therapy might also be recommended if your symptoms are making it difficult to perform your usual daily activities. Other types of therapy that might be helpful include:

• Intravenous immune globulin and plasma exchange might be considered if physical therapy and medications are not reducing your symptoms enough. This therapy works to suppress immune activity.

• Transcutaneous electrical nerve stimulation may help with pain. It involves using different frequencies of a gentle electric current to affect your nerves.

PREVENTION METHODS

There is no way to 100 percent prevent this diabetes complication. However, keeping your blood sugar levels in check can reduce your risk significantly. The first step is monitoring your glucose levels regularly so that you can determine if they are getting too high. You should also take all of your medications exactly as directed. If your treatment regimen is not keeping your blood sugar levels within the healthy range, talk to your doctor about making adjustments. Other ways to help to maintain healthy blood sugar levels include:

• Exercise most days of the week to increase insulin sensitivity, allowing your body to use blood glucose more effectively

• Reduce your intake of carbohydrates, and when you do eat carbohydrates, stick to complex carbohydrates since these will not cause an acute spike in your glucose levels (examples of complex carbohydrates include whole grains, beans and lentils)

• Eat more fiber to reduce how quickly your body absorbs sugar and digests carbohydrates to reduce blood sugar spikes

• Stay hydrated by drinking plenty of water to aid your kidneys in essentially flushing out excess glucose

• Eat smaller portions more frequently to better regulate your blood sugar levels

• Keep your stress under control since glucose levels can be negatively affected by excessive stress

• Make sure to get enough sleep to ensure better insulin sensitivity

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Diabetic Bracelets

Diabetes can affect all areas of your life, so it is important to consider your diabetes at all times. This includes letting medical personnel know that you are a diabetic. Diabetic bracelets are the easiest way to make it obvious that you are a diabetic. When people see your bracelet, they will know what type of diabetes you have so that any care provided can be tailored to this.

WHY MEDICAL ALERT BRACELETS FOR DIABETICS ARE IMPORTANT

All people with diabetes should have a diabetes medical alert bracelet. This tells first responders and other people that you are a diabetic to help to ensure the safest treatment possible during a medical emergency. Should you be unable to speak for yourself during an emergency, diabetic bracelets will tell those helping you what they need to know to provide the most accurate care possible. Both children and adults with diabetes should have a bracelet for diabetes because:

• Low blood sugar symptoms can mimic a lot of other issues, such as heart problems or alcohol intoxication, so when you are wearing your bracelet, it allows first responders to know that they need to check your blood sugar immediately to see if it is the cause of your symptoms

• You can often be treated faster since this bracelet allows medical personnel to more quickly narrow down the possible cause of your symptoms

• By knowing which diabetes medicines you are taking, it allows medical personnel to avoid administering any drugs that could adversely interact with the medications you take

• Medical personnel can avoid giving you any medications that you are allergic to since bracelets for diabetes also typically include your allergies

• When you list your emergency contact, first responders can quickly get in touch with them to get more details about your diabetes and overall health to provide more accurate care

• If you have an insulin pump, your medical bracelet will state this so that medical personnel know that you cannot have an MRI

INFORMATION TO INCLUDE ON YOUR DIABETIC MEDICAL ALERT BRACELET

It is important that you include all of the pertinent details about your diabetes and other health conditions on your bracelet for diabetes. You should put whether you take insulin on the bracelet. It is also important to state the type of diabetes you have. Make sure to include other diabetes medications in addition to insulin that you are taking. To ensure that first responders have all of the pertinent information, your bracelet should also include the following:

• Your allergies

• If you have an insulin pump or other implanted medical device

• Your chosen in-case-of-emergency contact person and their phone number

Any other pertinent medical information should also be on your bracelet. In addition to your diabetes medicines, any other medicines that could impact an emergency situation should be listed, such as those for an abnormal heart rhythm. You should also list any other serious medical conditions, such as kidney failure or heart disease. Ideally, your medical alert bracelet should provide first responders with a quick snapshot of your diabetes and your overall health.

TYPES OF BRACELETS FOR DIABETICS

There are several styles of diabetic bracelets. The best one for you will ultimately depend on your personal preference. Most of these bracelets are made of durable metals, such as stainless steel, or a more flexible material like silicone or rubber. If you experience rashes from metal when you sweat, you should opt for one of the flexible materials. Those with a latex or nickel allergy should consider this to make sure that they do not choose a bracelet that contains these materials.

When you are looking at the bracelet options, you also need to think about the type of closure. If you have issues with your hands, such as arthritis, one with a Velcro closure is a good choice. These are easy to close and remove when needed. This type of closure is also a good choice for kids. Some of these bracelets have a band like a watch band with a buckle to make sure that they remain in place.

Some diabetic bracelets use technology to deliver the information about your health. If your diabetes is complex, or if you have several medical conditions, this type of medical alert bracelet can be a good choice. Since the information about your health is not imprinted on a plate, you can add a lot more information. When someone sees your bracelet, they can scan it or call a phone number to get the details about your diabetes and other health conditions.

CAN YOU GET A DIABETIC MEDICAL ALERT BRACELET FOR FREE?

For those who meet federal poverty level guidelines, it is sometimes possible to get a free diabetic medical alert bracelet. You can check with local diabetes organizations or with your doctor to determine if you qualify for this type of service. It is important to note that free medical alert bracelets for diabetics might not be as personalized as those that you buy yourself. Because of this, if you want to have specific information on your bracelet, it is often best to purchase one.

IS A BRACELET BETTER THAN A NECKLACE?

In many cases, a bracelet is more visible than a necklace since a necklace can get tucked under your shirt. A survey of first responders showed that approximately 95 percent of them look for a medical ID bracelet when they are attending to a patient. Also, one of the first things emergency medical personnel do is check blood pressure, so this requires that they move your sleeves up. When they do this, if you are wearing a bracelet for diabetes, they will see if immediately. This will provide them with the information they need to know about your underlying condition.

WHICH WRIST SHOULD YOU WEAR YOUR BRACELET FOR DIABETES ON?

Since you should be wearing your bracelet for diabetes at all times, it is best to wear it on your non-dominant hand. This way you can wear the bracelet without it getting in the way when you are doing things like writing or home chores. Make sure that your bracelet fits well without being too tight so that it is comfortable to wear. Also, it should not be loose enough to slide off of your wrist so that you do not lose it.

You should also be mindful regarding the other wrist jewelry you are wearing on this wrist. It is okay to wear another small bracelet, but you want to make sure that your diabetes medical alert bracelet is as unobstructed as possible. Avoid large bangle bracelets or other jewelry that might cover your bracelet for diabetes or make it hard for people to see. Ideally, you should only wear your medical bracelet whenever possible.

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