Why does blood sugar still not meet the standard even though insulin is injected every day? Mr. Zhang was admitted to the hospital for diabetes, and his blood sugar was stable in the hospital, but when he came home and injected insulin on his own every day as requested by his doctor, his blood sugar fluctuated severely. The nurse asked him how he played, and Mr. Zhang looked puzzled and said, “Can’t I just put the medicine in?” The nurse looked at his medication and laughed. It turns out that Mr. Zhang is using premixed insulin, each injection before the full mix of the two insulins to play the effect, and he did not know, equivalent to injecting short-acting insulin before the medium-acting insulin, blood sugar naturally fluctuates greatly. Insulin treatment should also be individualized Pan Qi, deputy chief physician of the Department of Endocrinology, Beijing Hospital, Ministry of Health, said that type 1 diabetes is the main type of diabetes that requires insulin treatment, because type 1 diabetes is an absolute lack of insulin; for patients with type 1 diabetes, early insulin can be treated with drugs if there is no lack of insulin, but when the following conditions arise, insulin replacement or intensive treatment is required, first, the disease has progressed to a late stage Firstly, when the disease develops into late stage and the oral hypoglycemic drugs cannot control blood sugar well; secondly, when there are more serious complications; thirdly, when the patient is in a stressful state such as pregnancy or surgery. Therefore, insulin therapy should also be selected individually according to the patient’s condition. The type of insulin chosen is also important. Some patients have high blood sugar fluctuations and are suitable for intensive treatment, such as short-acting insulin injection before three meals and long-acting insulin injection before going to bed; however, some patients cannot guarantee insulin injection several times a day due to work, travel and other situations, and doctors can choose premixed insulin or basal insulin injection with oral medication for them. The absorption of insulin injected in different parts of the body is also different. Generally, the abdomen has more subcutaneous fat and is absorbed quickly, so it is suitable for short-acting insulin; the arm or hip has more muscle tissue and is absorbed slowly, so it is suitable for medium- or long-acting or premixed insulin. Rejecting insulin injections for different reasons In the clinic, it is common to see patients who do not want to receive insulin injections for various reasons. Pan Qi said that doctors have different strategies for patients of different ages. Most adolescents reject insulin treatment because they have a fear of injections and are afraid of pain. In this regard, doctors will make the child accept it through various methods, such as letting the child hit a rag doll with a syringe or through simulated skin injection, so that the child can see that the eye of the insulin injection is very small and the pain is very little, and gradually make the child accept the transition to injecting himself. Many adult patients who reject insulin therapy believe that once insulin is administered, they can never stop. At this point, the doctor needs to make the patient look forward to and anticipate the prospect of treatment. On the one hand, let patients understand the benefits of good blood sugar control to reduce complications and later in life. For some type 2 diabetes, let them know that insulin injections do not need to last a lifetime, and that they can also be treated with oral medication once the stressful state such as childbirth or surgery is over. This way the patient is relieved of the fear of endless insulin injections and will be more cooperative with treatment. Problems that often arise in the elderly are mostly concentrated in those without children or elderly companions. The elderly often have poor eyesight, slower reaction time, do not respond to hypoglycemia, do not master the injection method as quickly as younger people, etc. This requires doctors to simplify the treatment for the elderly and avoid complications, and not to give a second injection if the problem can be solved by one injection. In addition, the blood sugar control of the elderly can be appropriately relaxed and does not need to be as strict as the young people. Common misunderstandings of insulin injection Pan Qi told reporters that patients with unstable blood sugar due to improper insulin injection as mentioned in the opening paragraph are very common, partly because of the patients’ own problems, and partly because the doctors and teaching nurses may not educate the patients appropriately to let them know the correct operation specification. Unlike other diseases, diabetes requires lifelong treatment, and insulin is one of the important treatment modalities. If patients are injected incorrectly, it can have a significant impact on disease control and impact. The following are common injection misconceptions of patients. 1, do not change needles Many diabetic patients are reusing needles, some for cost reasons, others feel no need to replace them again and again. Pan Qi said that insulin injection needles are now ultra-fine, painless needles to reduce the patient’s fear of injection due to fear of pain. Researchers observed under the microscope found that painless needles have a protective film outside, which protects the sharpness of the needle and does not hurt when injecting. However, the observation of used needles found that not only has the protective film fallen off, the needle will also become blunt, the epidermis forms barbs, and the pain is obvious when the needle is pulled out, causing the patient to have a fear of injection. In addition, repeated use of needles can also cause problems such as clogged syringes and inaccurate injection doses. 2, the same location repeatedly injected Some patients came to the hospital, found that the abdominal injection site skin is not the same flat, one side obviously bulge out, with a touch, there are large hard nodules inside. Pan Qi said that these hard knots are fat masses caused by injections in the same location. Insulin is a hormone that promotes fat and protein synthesis, and always injecting in one place will cause fat accumulation, which will affect the absorption of insulin next time. The correct method of injection is not to have each injection site too close to each other, at least 1cm apart; and to alternate injections, once on the left and once on the right, or carousel injection, so that insulin can play a big role to avoid waste and blood sugar fluctuations. 3, anxious to pull out the needle after injection If the needle is still dripping when it is pulled out, it means that the time to keep the needle is not long enough and the drug does not reach the subcutaneous completely. Pan Qi said that the skin is under a certain pressure, and the drug should slowly penetrate into the subcutaneous tissue through the tiny needle, but the subcutaneous tissue structure is very dense, and you should count about 10 seconds after entering the needle and then pull out, so as not to cause insulin waste and affect the treatment effect. 4. Responding to allergy symptoms It is not common for patients to have allergy due to insulin injection, but some patients do have symptoms such as severe itching or red rash nodules due to allergy. Generally, there are three reasons for allergy. Some patients are allergic to insulin itself; others are allergic to additives in the pharmaceutical process; and still others are allergic to the antiseptic before injection. For patients who are allergic to insulin, the doctor will first look at the type of insulin he used. Some patients inject animal insulin, which has different amino acids from human insulin, and after injection the body will produce antibodies and have an allergic reaction. In this regard, doctors will advise patients to inject human insulin or insulin with higher purity. Other patients are allergic to protein, zinc and other additives added in the process of insulin preparation, and can undergo desensitization therapy or adjust the treatment plan to supplement medication to reduce allergic reactions. Some patients are also allergic to pre-injection disinfectants such as alcohol, and the doctor will advise the patient to change the disinfection method and avoid repeated injections at the same site.