Confirming Insulin Use in Patients

Physical Examination Approach

Look for needle marks, bruising, or redness at common injection sites, as recommended by the American Diabetes Association, to confirm insulin use 1
Observe for rotation patterns within injection areas, as proper rotation is recommended to prevent tissue changes, according to the American Diabetes Association 1, 2
Note that the abdomen has the fastest rate of absorption, followed by the arms, thighs, and buttocks, which may be visible in patients using insulin, as stated by the American Diabetes Association 2

Review blood glucose monitoring records for patterns consistent with insulin administration, as suggested by the American Diabetes Association, to identify potential insulin use 2
Look for unexplained hypoglycemic episodes, which may indicate insulin use, according to the American Diabetes Association 2
Monitor for patterns of low blood glucose corresponding to expected peak insulin action times, as recommended by the American Diabetes Association, to confirm insulin use 1

Inspect the patient's insulin vials or pens for proper storage, signs of use, expiration dates, and visual changes in insulin appearance, as recommended by the American Diabetes Association, to verify insulin use 3, 4, 5
Check for the presence of insulin administration supplies, including proper sharps disposal containers, as suggested by the American Diabetes Association, to ensure safe disposal practices 6

Verify the patient's knowledge of proper mixing technique for cloudy insulins, as recommended by the American Diabetes Association, to ensure correct insulin administration 3
Confirm the patient's understanding of correct injection angle and site rotation practices, as suggested by the American Diabetes Association, to prevent tissue changes 1, 7
Request that patients demonstrate their insulin storage methods, as recommended by the American Diabetes Association, to ensure proper storage and handling of insulin 4