Insulin is applied by subcutaneous injection , usually using a pen or continuous infusion insulin pump .
The type of insulin given to diabetic children and adults is the same: a slow-acting insulin to mimic the ongoing pancreatic insulin release that occurs (in general, the glargine and detemir analogues), and a fast-acting insulin to metabolize the insulin. blood glucose that rises in blood after each meal (the analogs: lispro, apidra and aspart), always trying to mimic the normal pancreatic secretion of the healthy individual.
Subcutaneous injections usually use insulin pens (slow and fast). Slow insulin is put in one or several daily injections and the fast one, before each meal. Therefore, each patient must have a minimum of 4 daily injections: one of slow and 3 of rapid (before breakfast, lunch and dinner). But it is very common that they have to increase the number of daily injections that should be administered. Only fast-acting insulins are used in infusion pumps. Insulin passes through a small catheter inserted under the skin and must be changed every three days (maximum four), so patients carrying infusion pumps only prick every three or four days.
The insulin adjustment is made taking into account the blood glucose level control performed by the patient with a glucometer. Control should be done 6 times daily: before and two hours after meals and, often, also at 3 in the morning. The control of before each meal, in crucial to define the amount of insulin that must be injected since it is necessary to adapt it to the figure that they have obtained. Likewise, it is necessary to know how to count the carbohydrates they are going to ingest (also take into account the proteins and fats contained in the food), as well as the exercise they are going to perform or have done, so that the dosage of the insulin is as accurate as possible depending on the needs of the moment.
Therefore, these patients require exhaustive knowledge that they only acquire progressively through a continuous and demanding diabetological education.