National Diabetes Reference Materials - An initiative under the War on Diabetes
Liver, fat tissues and muscles E.g. Pioglitazone, metformin
Reduces amount of sugar made by the liver, and increases the sensitivity of fat, liver and muscle cells to insulin
Liver and pancreas E.g. Linagliptin, sitagliptin
Helps the pancreas produce more insulin and reduce amount of sugar made by the liver
KidneysE.g. Dapagliflozin, empagliflozin
Prevents the kidneys from re-absorbing sugar
IntestinesE.g. Acarbose
Slows down breakdown of starch and absorption of sugar from the intestines
PancreasE.g. Glipizide, tolbutamide, gliclazide
Helps the pancreas produce more insulin
Take your medication(s) regularly at the correct time(s)
If you miss a dose, take it as soon as you remember; if it is time for the next dose, skip the missed dose
Eat meals regularly to prevent hypoglycaemia (low blood sugar)
Avoid taking alcohol with medication
Taking metformin before going for any scans (e.g. X-ray) or procedures
Pregnant or planning to get pregnant before taking medication
Experiencing persistent symptoms of hypoglycaemia (low blood sugar)
1. Vial
2. Syringe and plunger
3. Swab
Follow these steps to prepare your single or mixed insulin
1. Gather your supplies(syringe, insulin, alcohol swabs)
2. Wash your hands with soap and running water then dry your hands thoroughly
3. Roll the vial insulin (if the insulin is cloudy)between the palms of your hands to mix it and/or warm it up to body temperature
4. Clean the rubber stopper on the vial with an alcohol swab
After completing part 1 (preparation), follow these steps to draw a SINGLE dose of insulin into the syringe
1. Draw air into the syringe to the level prescribed for your insulin dose
2. With the vial standing upright, inject the air dose into the vial by pushing down the plunger
3. Turn the vial and syringe upside down, ensure the needle tip is covered by the liquid
4. Pull back the plunger to withdraw insulin to the level of the prescribed dose
5. Gently flick the side of the syringe to remove air bubbles, if needed
After completing part 1 (preparation), follow these steps to draw a MIXED dose of insulin into the syringe
1. Draw air into the syringe to the level prescribed for your cloudy insulin dose
2. Insert the syringe into the cloudy vial and inject the air dose into the vial by pushing down the plunger - remove the syringe without drawing the insulin
3. Draw air into the syringe to the level prescribed for your clear insulin dose
4. Inject the air dose into the clear vial in an upright position
5. Turn the vial and syringe upside down ensure the needle tip is covered by the liquid
6. Slowly pull back the plunger to withdraw clear insulin to the level prescribed
7. Removed the partly filled syringe from the clear vial and insert it in the vial of cloudy insulin
8. Turn the vial and syringe upside down, and slowly withdraw to the level prescribed for total amount of insulin (clear + cloudy)
Step-by-step guide to injecting insulin into your chosen site
1. Clean your chosen site with water and tissue
2. Lift the skin with your thumb and finger on the chosen site. With your other hand, hold the syringe (like a pencil, keeping fingers off the plunger) close to the chosen site at a 90 degree angle
3. Push the syringe all the way into the pinched skin fold, then push the plunger all the way down to deliver insulin into the fatty tissue
4. Withdraw the needle from the skin at the same angle that it was inserted and then release the skin fold
1. For cloudly insulin roll the pen in between your palms in a horizontal motion 10 times
2. Clean the rubber membraine with an alcohol swab before attaching the insulin needle onto the insulin pen
3. Dial 2 units by turning the dose selector
4. Hold the insulin pen with the needle upwards and tap the cartridge gently with your finger a few times to let air bubbles collect at the top of the cartridge
5. With the insulin pen still pointing upward, press the push button all the way (in the dose selector should return to "0", and a drop of insulin should appear at the needle tip)
6. Select the dose of insulin you need
Wash your hands with a soap and water
Dry hands with a tissue paper or hand towel
Select the injection site at your abdominal area
Clean the chosen site with water and tissue
Wait for the site to dry
Pinch a skinfold using your thumb and index finger
Inject the insulin at 90 degrees perpendicular to the injection site
Inject the dose by pressing the push-button all the way in until '0'
Keep the push-button down fully for at least 6 seconds (to ensure the full dose has been injected) and as you withdraw the needle from your skin
Place the outer needle cap on the table. Direct the needle tip into the outer needle cap without holding on to it (to prevent finger stick injury). Unscrew and dispose the needle after it covered
Store the insulin pen at room temperature after injection, away from direct sunlight and heat
Visual guide to show where you can inject insulin
Move 2 fingers along from your last insulin injection site
Quick tips on storing and handling your insulin
1. Write the date on the vial on the day you open it
2. For open vials or pens, store them at room temperature and away form direct sunlight
3. For unused vials or pens, store them in the fridge, not the freezer
4. Avoid shaking the insulin vial excessively to prevent air bubbles forming
5. Discard the insulin if expired (30 days after openning), contaminated, or if there are insoluble particles
Proper disposal protects cleaners from accidental injuries, and prevents your used syringes and insulin pen needles form falling into the wrong hands
1. Place used syringes and insulin pen needles in a hard puncture-resistant container with a securable lid
2. Label the container "Used syringes and insulin pen needles"
3. Seal the container when it is full
4. Discard the container down the rubbish chute or in a rubbish bin
To note: Discard all used syringes and insulin pen needles do not reuse them. Containers that are suitable for safe disposal must be hard plastic, metal or sharp container, such as an empty detergent bottle or metal tin