Top 5 Must Do’s to becoming FITTER1

Check at every visit or when appropriate:

1. Injection sites

Lipohypertrophy or other lesion found by observation and palpation
Support patient to:

  • Avoid injecting into lipohypertrophy areas
  • Monitor blood glucose levels frequently
  • Reduce insulin dose as required to avoid hypoglycaemia
  • Properly rotate injection sites
  • Use shortest needle length (4mm) to minimise risk of intramuscular injection
  • Use each needle once
  • Inspect injection sites regularly (at least annually) to detect lipohypertrophy early
2. Injection technique

Optimise injection technique (use image on FIT wheel)

  • Teach correct injection technique- encourage correct rotation of sites
  • Use 4mm pen needle
  • Use lifted skin fold if necessary to avoid accidental intramuscular injection
3. Insulin is correctly stored & re-suspended

Insulin no longer viable

  • Dispose of all date expired or poorly stored insulin
  • Replace expired or poorly stored insulin with new viable insulin
4. Pen device, pen needle, syringe & infusion set

Check injection equipment

  • Replace broken pen device with functioning device
  • Match cartridge with correct pen
  • Advise single use only for pen needles
  • Replace infusion set every three days or when occluded
  • Check blood glucose meter and replace if malfunctioning
5. Food, activity & insulin dose all correct

Food and Activity

  • Review ratios and correction doses
  • Support patient with advice on all aspects of daily life and diabetes management and refer for specialist advicefrom diabetes specialist team as appropriate
  1. The First UK Injection Technique Recommendations
    4th Edition 2016
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