There are many known and practised schemes of human insulin treatment. A physician must choose and individually adjust a treatment to a patient, according to the requirements. Basing on the insulin concentration in a patient's blood a physician adjusts, a proper insulin dose and an insulin preparation. The patient mustn't apply any other insulin preparation except the one recommended by the physician. The patient shouldn't mix a prescribed by physician insulin with another preparation if the physician did not recommend it. Before use, the patient should always check on the label the name and a code of the insulin in the vial and make sure it is identical with the prescribed one.
The patient should check the expiry date on the container. Do not apply after the expiry date.
Administration: MODE OF USE: GENSULIN preparations are for subcutaneous injection. Gensulin N, M10, M20, M30, M40, M50: Suspension and mixtures should be homogeneously opaque (uniformly cloudy or milky). They should not be used if after mixing they remain clear or there is a film of white substance at the bottom, there are white clusters floating, or solid, white particles remain stick to the walls making the preparation look frozen.
Before applied, the preparation should be softly shaken a few times and the vial turned upside down in order to mix the preparation well. Do not shake the vial vigorously. The patient must be especially careful not to introduce insulin into a blood vessel during the injection.
Administration of GENSULIN preparations with syringes: Only especially designed syringes with insulin concentration marked on them can be used for insulin administration. When the patient is lacking disposable syringes and needles, the patient may apply multiple use ones but must sterilize them each time before the injection. It is recommended to use syringes of one type by the same producer. Always check if a syringe has been graduated in accordance with the applied concentration of the insulin preparation.
Mode of preparation: Remove the safety tear-off lid on the vial.
Rub the vial plug with alcohol solution. Do not take it out.
Take into the syringe equal to the administered insulin volume of air.
Inject the air into the vial by puncturing the gum plug of the vial with the needle.
Turn the vial with the syringe upside down. Make sure the point of the needle is in the insulin.
Withdraw into the syringe proper amount of insulin solution.
Remove the air bubbles from the syringe by pumping them back into the vial.
Double check the recommended dose and take the needle out of the vial.
Disinfect the injection site on the skin.
With one hand stabilise the skin by pulling it or by pinching a large skin surface in order to form a skin crease.
Take the syringe in the other hand and hold it like a pencil. Shoot the needle straight into the skin (90° angle). Make sure the needle is properly shot and placed in the fat layer under the skin and not in the deeper layers of the skin (in very thin people it may be necessary to shoot the needle on the different from the square angle).
In order to inject insulin the patient must push the piston to the very end of the syringe within less than 5 seconds.
Hold the alcohol damped cotton close to the needle and take the needle out from the skin. Press the cotton for a few seconds on the injection site. Do not rub it.
It is recommended to change the puncture site with each injection in order to avoid tissue damages. The succeeding puncture site should be at least 1-2 cm away from the previous one.
MIXING GENSULIN R SOLUTION WITH GENSULIN N SUSPENSION OR MIXTURES (M10, M20, M30, M40, M50): Only the physician can decide about mixing Gensulin R with the suspension or mixtures. When preparing a mixture, the patient should always introduce a short time-effect insulin first into a syringe, that is Gensulin R. The patient should carry out the injection in the same way as described above.
INSULIN IN CARTRIDGES: Some Gensulin preparations are produced in cartridges which may be applied with multiple-use pen injectors.
In order to operate the injector (load the cartridge, insert the needle, carry out the injection) the patient must strictly observe the producer's instructions.
The patient should not use injectors by different procedures. In emergencies the patient may use the cartridge insulin in a normal insulin syringe and proceed as described above (in accordance with the insulin concentration and dose).