Common methods of insulin injection

  1.Three injections therapy: It is used for people with type 1 diabetes who still have some endogenous islet function or type 2 diabetes who have conditions to self-monitor blood sugar. Generally, starting from a small dose, short-acting insulin is injected subcutaneously 30 minutes before three meals. Short-acting insulin can also be injected before breakfast and lunch, and short-acting insulin plus a small amount of medium-acting insulin (or long-acting insulin) can be injected before dinner. The three-injection therapy is close to the physiological state, easy to adjust the insulin dose, and is a common clinical treatment method. It should be noted that: if the medium-acting insulin dosage before dinner hours, fasting blood sugar control is not good; if the dosage is large, hypoglycemia can occur at 12:00-3Am at night. Within a day, the dosage used before breakfast is generally the most, before dinner is the second most, and before Chinese food is the least. After 3-5 days, the insulin dosage can be adjusted according to the situation of blood sugar 2 hours after meals.  2.Four injections therapy: that is, on the basis of three injections therapy, a small dose (4-8u) of medium-acting insulin is injected before bedtime to control fasting blood sugar. This is also a common clinical protocol at present. The disadvantage is: since the effect of intermediate-acting insulin is maintained for 14-16 hours, a blank zone appears from 2PM the following day to before dinner if the basal insulin is deficient.  3, five injections therapy: that is, one injection of short-acting insulin before each of the three meals, and another injection of intermediate-acting insulin at around 8Am, and one injection of intermediate-acting insulin before bedtime. This is the most physiological mode of administration, but it requires five injections per day, which is not easily accepted by patients.  4.Second injection therapy: On the basis of three injection therapy, short-acting insulin is injected before breakfast and lunch in the ratio of the choice to mix insulin (Novolin 30R or 50R). This can reduce the injection before lunch, which is convenient for the patient, but the disadvantage is that if the blood sugar is satisfactory 2 hours after breakfast, hypoglycemia is easy to appear before lunch, such as a small amount of additional meals at 10Am, the blood sugar fluctuates after lunch, which is not easy to control. If there is too much medium-acting insulin before dinner, hypoglycemia can occur in the first half of the night, and if there is not enough medium-acting insulin before dinner, fasting blood sugar control is not satisfactory.  For type 1 patients, the best method is the 3rd five injections method, which is in line with physiological secretion, followed by the 2nd four injections method, which is recommended to use long-acting insulin at night. The three-injection method reduces the number of injections, and because there are too few types of insulin to be mixed in China, the blood sugar is not well controlled. The two-injection method is not suitable for type 1 patients.