Lesson Plan Content

Contents
Learning objectives..........................................................................................................................2
Introduction......................................................................................................................................2
Outline.............................................................................................................................................2
Importance of correct insulin administration...................................................................................3
Body.................................................................................................................................................3
Figure 1 Sites for insulin injection...................................................................................................3
Injection Technique:........................................................................................................................4
Demonstrate the steps of injection...................................................................................................4
Conclusion.......................................................................................................................................5
Reference.........................................................................................................................................6
1
Micro-teaching Lesson Plan Content
Lesson Title: Revision in self-administration of insulin injection
Class setting: In Diabetic clinic
Time available: 5 minutes
Student profile: Bhutanese old case type 1 Diabetic Patients; Age: 35-60 years; gender: female
and male; language (Dzongkha, English, Lhotshamkha and sharchopkha), with previous idea of
insulin administration; number: 4-5 numbers.
Learning objectives
In the end of the session patients will be able to;
1. List the importance of knowing how to administer insulin correctly

2. Understand the basic steps in insulin injection administration
3. Identify sites for insulin administration
4. Demonstrate the techniques for insulin administration correctly
Introduction
Greet audience and introduce self
Topic: Revision in self-administration of insulin injection
Outline
 Review about self insulin administration
 Importance of correct administration of insulin injection
 Identifying sites for subcutaneous insulin injection
 Steps for correct administration of insulin injection
 Summary
2
Importance of correct insulin administration
 To avoid hypoglycemia or hyperglycemia
 To avoid infection
 To avoid skin necrosis
Body
Injection Site Selection Rotation and Technique:
Rotation of the injection site helps reduce irritation and bruising and improves absorption. This is
especially important for lipohypertrophy (LH) prevention, a complication reported in nearly 50%
of individuals using insulin. LH is a swelling or hardening of fat tissue associated with injecting
into the same site over time without rotating sites (Spollett et al., 2016)
Teach individuals who are self-injecting medications to inspect the intended injection site prior
to injection by looking and feeling for hardened areas; to understand the need for regular site
rotation and to avoid injecting into areas of LH, inflammation, edema, scar tissue, moles or
infection (Saltiel-Berzin et al., 2012)
Figure 1 Sites for insulin injection
3
Injection Technique:
 When administering medication with a syringe, the needle should be inserted quickly (but
carefully), and removed from the skin at the same angle it was inserted. Very thin adults
should lift the skinfold and inserting the needle perpendicularly into it. When any syringe
needle is used slim to normal-weight adults, injections should always be given into a lifted
skinfold to lower the risk of IM injections (Frid et al., 2010).
 Injecting at a 45° angle using a 6-mm syringe needle is an acceptable substitute for lifting a
skinfold.
Demonstrate the steps of injection

 Wash hands prior to injecting medication.
 Disinfecting the site.
 Draw the insulin required
 Insulin should be injected into subcutaneous fat, avoiding muscle. Careful site selection and
use of shorter needles helps prevent intra-muscular (IM) injections. IM injections can lead to
glycemic variability and hypoglycemia as well as an increased risk of bleeding, bruising and
pain at the injection site (Saltiel-Berzin et al., 2012)
 The most desirable injection site is the abdomen (or stomach) for the most predictable
absorption. It is recommended to inject an inch apart each time, and rotate with each
quadrant, avoiding the area within two inches of the umbilicus or within one inch of the
hipbones.
 The back of the upper arms, the upper buttocks or hips, and the outer side of the thighs can
also be used, but encourage patients to avoid the areas if exercising that muscle group
(walking, running, weight lifting) soon after the injection as it may impact the speed of
insulin absorption.
 Inject the syringe at 45 degree at the selected site for normal weighted person; 90 degree for
fat people and pinch the skin fold for very lean people
 Dispose the syringe and needle in sharp container (Spollett et al., 2016)
4
Ask the audience;
 What are the sites for insulin injection?

 Can one of you re-demonstrate insulin administration?
Conclusion
Summary
The species and dosage of insulin used should be consistent, and the patient’s injection technique
should be reviewed periodically with the diabetes care team. The effective use of insulin to
obtain the best metabolic control requires an understanding of the duration of action of the
various types of insulin and the relationship of blood glucose levels to exercise, food intake,
certain medications, and stress and learning to adjust insulin dosage to achieve the individualized
target goals established between the patient, family, and diabetes care team.
Clarification
Expected doubts: Can we change the site of injection daily?
Answer: Yes, you can change the site every day or if you are getting your injection twice a day
you can change or rotate the sites each time you self-administer the injection.
5
Reference
Agazzi, M. L., Herrera, S. E., Cortez, M. L., Marmisollé, W. A., Tagliazucchi, M., & Azzaroni,
O. (2020). Insulin Delivery from Glucose‐Responsive, Self‐Assembled, Polyamine
Nanoparticles: Smart “Sense‐and‐Treat” Nanocarriers Made Easy. Chemistry – A
European Journal, 26(11), 2456–2463.
Frid, A., Hirsch, L., Gaspar, R., Hicks, D., Kreugel, G., Liersch, J., Letondeur, C., Sauvanet, J.
P., Tubiana-Rufi, N., & Strauss, K. (2010). New injection recommendations for patients
with diabetes. Diabetes & Metabolism, 36(2), S3–S18. https://doi.org/10.1016/s1262-
3636(10)70002-1
Managed care opportunities and approaches to select treatment for sight preservation. (2020).
The American Journal of Managed Care, 26(Suppl 5).
https://doi.org/10.37765/ajmc.2020.43436
Saltiel-Berzin, R., Cypress, M., & Gibney, M. (2012). Translating the Research in Insulin
Injection Technique: Implications for Practice. Diabetes Educator, 38(5), 635–643.
https://doi.org/10.1177/0145721712455107
Spollett, G., Edelman, S. V, Mehner, P., & Walter, C. (2016). Improvement of Insulin Injection
Technique. https://doi.org/10.1177/0145721716648017

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Contents

Lesson Title: Revision in self-administration of insulin injection

Class setting: In Diabetic clinic

Time available: 5 minutes

1. List the importance of knowing how to administer insulin correctly

Greet audience and introduce self

Topic: Revision in self-administration of insulin injection

Figure 1 Sites for insulin injection

Demonstrate the steps of injection

 What are the sites for insulin injection?

Expected doubts: Can we change the site of injection daily?

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