Which teaching information should be reinforced for a patient with diabetes who uses daily insulin injections upon discharge?

Which teaching information should be reinforced for a patient with diabetes who uses daily insulin injections upon discharge?

• A. Increase the amount of insulin before unusual exercise.
• B. Rotate the insulin injection sites systematically.
• C. Keep insulin vials refrigerated at all times.
• D. Monitor the urine acetone level to determine the insulin dosage.

Answer: (B)

Rotating insulin injection sites is essential because absorption can vary from one site to another, and repeatedly injecting into the same spot can create lipohypertrophy or lipodystrophy. These changes in tissue make insulin absorption inconsistent, which can lead to unpredictable blood glucose levels and episodes of hypoglycemia or hyperglycemia. A systematic rotation plan—using different spots and moving injections around within regions while avoiding the exact same tiny area repeatedly—helps keep absorption steady and improves overall glycemic control. In practice, use multiple sites such as the abdomen, thighs, arms, and buttocks, and ensure you don’t inject into recently used areas; document or map rotations so tissue has time to recover. For storage, unopened vials should be kept refrigerated, but once in use many insulins can be stored at room temperature for a limited period, away from heat or light. Urine ketone testing isn’t used to set insulin doses; dosing relies on blood glucose readings, meals, activity, and illness rather than urine acetone levels.

Rotating insulin injection sites is essential because absorption can vary from one site to another, and repeatedly injecting into the same spot can create lipohypertrophy or lipodystrophy. These changes in tissue make insulin absorption inconsistent, which can lead to unpredictable blood glucose levels and episodes of hypoglycemia or hyperglycemia. A systematic rotation plan—using different spots and moving injections around within regions while avoiding the exact same tiny area repeatedly—helps keep absorption steady and improves overall glycemic control. In practice, use multiple sites such as the abdomen, thighs, arms, and buttocks, and ensure you don’t inject into recently used areas; document or map rotations so tissue has time to recover. For storage, unopened vials should be kept refrigerated, but once in use many insulins can be stored at room temperature for a limited period, away from heat or light. Urine ketone testing isn’t used to set insulin doses; dosing relies on blood glucose readings, meals, activity, and illness rather than urine acetone levels.