Microsoft word - injecting insulin checklist - self adjust bedtime.doc

Injecting insulin checklist
Check when
Why this is important
2. Check insulin’s expiration date (the date date recorded after opening the cartridge). Do not use clear insulin that appears cloudy, discoloured or contains solid particles. Do not use □□□□□□□ yellowish or lumpy. These insulins may not work well. Overusing a site can cause bumps, cracks or scarring that may □□□□□□□ controlled blood glucose. Reusing needles can increase the 7. For cloudy insulin only, If cloudy insulin is not re-gently mix/roll the insulin suspended, insulin absorption may □□□□□□□ 8. Prime the pen with 2 units prior to each use. If prime the pen with 8-10 units. 9. Hold injection for at a “sharps” container. You properly reduces the risk of injury □□□□□□□ Produced by the Hamilton Family Health Team Registered Dietitians 10 George Street, 3rd Floor, Hamilton, ON L8P 1C8. 905-667-4848 Self Adjustment of Bedtime Insulin
Your physician has prescribed a bedtime insulin called:
Humulin N OR Novolin NPH OR Lantus OR Levemir
The combination of insulin at bedtime plus diabetes pills during the day is an effective
way of controlling blood glucose levels. Bedtime insulin will help improve blood glucose
levels before breakfast. The dosage required can be determined by checking your blood
glucose levels regularly. This sheet will help you find the right dose of insulin to give
yourself at bedtime.
Procedure:

1. Start with a dose of 10 units of insulin at bedtime. Generally Humulin N and Novolin NPH are injected at around 10 pm. This allows for the peak action of these insulins to coincide with high morning blood glucose levels. Lantus and Levemir can be injected at any time. Injection times for all insulins must be as regular as possible. 2. Check your blood glucose every morning before breakfast (and at other times as indicated by your health care provider). Before meal blood glucose levels should be between 4 – 7 mmol/L. 3. If your blood glucose reading before breakfast is higher than 7 mmol/L for 2 days in a row, increase the bedtime insulin by 2 units. 4. Every 2 days, increase your bedtime insulin by 2 units until your fasting blood 5. If you have a before breakfast glucose reading less than 4 mmol/L for 2 days in a row, reduce the bedtime insulin by 2 units. 6. Often a high blood glucose reading in the morning can occur following a low blood glucose “insulin reaction” in the middle of the night. Symptoms include bad dreams, damp bed sheets from sweating, morning grumpiness and/or headache. Check your blood glucose levels at 3 am once a week (or more it needed). If you have a low blood glucose reaction during the night, reduce the bedtime insulin by 2 units, even if the morning blood glucose is high. If you have any problems or questions, please call the office at: _____________ Produced by the Hamilton Family Health Team Registered Dietitians 10 George Street, 3rd Floor, Hamilton, ON L8P 1C8. 905-667-4848

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