NHSL Medicines Guidance
Insulin is frequently in the list of top 10 high-alert medicines (those with the highest risk of causing patient injury – National Patient Safety Agency June 2010) and should be prescribed using the brand name with the dose in UNITS (do not abbreviate to U or IU).
- Insulin should NOT be withdrawn from an insulin pen or pen refill and then administered using a syringe and needle.
- Cartridges are generally more cost efficient than pre-filled pens.
- Reusable pens are specific to the insulin prescribed.
- Spare insulin should be stored in the fridge.
- An 8mm needle is the preferred choice in those with Type 2 Diabetes.
- A new needle should be used for each injection as the needle degrades after just one use and can impact on the effectiveness of insulin therapy.
- Needles should be disposed of using a needle clipping device, available on prescription.
- Injection sites should be rotated and avoided if lumpy (lipohypertrophy), as this may affect the absorption of insulin.
- Injection of insulin can lead to deposits of amyloid protein under the skin (cutaneous amyloidosis) at the injection site. This may affect glycaemic control.
- The MHRA advises healthcare professionals should consider cutaneous amyloidosis as a differential diagnosis to lipodystrophy when patients present with subcutaneous lumps at an insulin injection site.
For inpatient guidance please refer to the NHSL Administration of Insulin in Hospital document.