G.Notes

1. Storage and Expiry of Insulins
   1. Keep unused insulin vial and pens of insulin in the refrigerator (between 2°C and 8°C);Keep insulin vial and pens that you're currently using at room temperature .(between 15°C and 30°C.)Keep your insulin away from heat and light. Whether or not refrigerated, open(used) vial or pen must be used within 28 days.
   2. Always carry your insulin and supplies with you in your carry-on luggage. Do not place insulin in your checked luggage.
2. The most common side effect of insulin is low blood sugar, or hypoglycemia. Important tips to remember about injecting insulin and avoiding low blood sugar:
   1. If you take Short-acting or rapid-acting insulin before meals, inject the insulin when you sit down to eat.
   2. If you need to take blood on an empty stomach On the day of your appointment, you need to prepare insulin and breakfast together and bring them to the hospital.
   3. After the blood draw is completed, you can take insulin and breakfast. Do not take Insulin without eating before going to hospital.
   4. Do not massage or apply heat therapy to the injection site. Massage and heat increase tissue blood perfusion and, thereby, the absorption of subcutaneously applied insulin.
   5. Insulin should be injected (subcutaneously) into the fatty layer under your skin. If you inject it deeper into your muscle, your body will absorb it too quickly, it might not last as long and the injection is usually more painful. This can lead to low blood glucose levels.
   6. Must inject correct unit mark for your insulin dose as ordered and monitor your blood glucose level at home.
3. Rotating Injection Sites
   1. Selecting the injection site (brown area)
      1. Abdomen：When injecting into the abdomen, you should avoid the belly button because the belly button is tougher and makes insulin absorption less consistent. Instead, inject insulin at least one finger length (or 1 cm) away from the belly button.
      2. On the upper arms：Using the fleshy area on the side and back of the arms. Avoid the muscle in the shoulder. Stay three to four finger-widths away from the elbow.
      3. On the thighs：Using the top and outer areas only. Do not use the inner side or back of the thigh. Stay about three to four finger-widths away from the knee and groin.
      4. Upper Buttocks：Inject the outer top of the buttocks, where a pant belt would sit.
   2. Rotating insulin injection sites
      1. Injection site rotation is the systematic switching of insulin injections from one site to another. The best way to control blood sugar is to aim to use the same site at the same time of day daily and to rotate within that site. Inject at least one finger-width away from your previous injection site to avoid developing lipo (fatty lumps) at your injection sites
      2. Avoid injecting into existing lipos, scars, beauty marks or any other skin abnormality, because it can change the way your diabetes medication is absorbed.
      3. Lumps, bumps or local redness and swelling that may appear at injection sites. If there is any situation, you need to respond to the doctor or nurse.
      4. In pregnant women, the abdomen becomes larger and tighter. Insulin usually is given in the upper arm, thigh or upper buttock.
4. After the insulin injection, you can record your injection time, dose, whether there is bleeding or medicine at the injection site, pain, etc.
5. Tips to help avoid or minimise pain when injecting, include:
   1. Use insulin and a needle which is at room temperature.
   2. Before injection, check whether there is air in the empty needle.
   3. Let alcohol cleaning dry before injection.
   4. Push the needle in quickly when injecting.
   5. Try not to wiggle the needle as you're injecting or withdrawing the needle.
   6. Always use a new needle.
   7. Use a needle that is the right length.
   8. Relax to avoid tensing.
6. If you have any questions about insulin injection, please connect your doctor or nurse.