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What are reasons for 10 second rule when injecting...

Molly56

Molly56

Well-Known Member
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3,844
Type of diabetes
Don't have diabetes
Treatment type
I do not have diabetes
Apologies for duplication from another thread but wanted to ask advice about 10 second rule on injecting....

....background info from other thread....
Molly56 said:
Just wondered how common it is to experience pain on injecting or bleeding from injection site....my partner seems to often experience these when injecting his insulin (Novomix 30 FlexPen / Mylife Penfine Classic 4mm needles).....injecting into stomach area.......is this usual or is there a way of minimising this...
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Molly56 said:
Have just been reading around on forum and am wondering if my partner's injection technique is part of the problem.....he always injects in the stomach area and doesn't pinch the skin when injecting....I have also noticed that he only holds it in place for two or at the most three seconds before withdrawing the needle and saying 'that's done'...

Am i correct in assuming that holding the needle in place for the ten seconds as recommended would allow for the insulin to be absorbed into the fatty layer before withdrawing leading to better overall absorption......and that pain and bleeding would be less likely to occur as insulin would not be leaked out.

Is difficult for me to criticise his injection technique as he is reluctant to listen to what I have to say and thinks he is doing it correctly....however if I can say that holding it in place longer will help to minimise any pain or bleeding perhaps I can get him to try it this way for a while and see if it improves.

As far as injection sites go he has only ever used his stomach as is the easiest part to get to....and don't think (know) he has any particular system in place as to where in his stomach he will inject....would guess that most injections are roughly in the same place depending on which hand he holds his insulin pen in.....i have vaguely mentioned moving the injection site around but he wouldn't remember where he had done it last time anyway...
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How is the best way of explaining the 10 second rule when injecting insulin....what are the reasons behind this...is it to do with absorption or minimising leakage.....why 10 seconds...what happens if you do less than 10 seconds....

Am just wondering how I can best explain this to my partner to improve his injection technique and perhaps minimise the pain and bleeding he currently experiences......and if those problems exist because of poor injection technique..

@Shar67 did suggest (on other thread) getting the dn to explain this to him but unfortunately I am unable to go to his next appointment with him to ask the question and regardless of this being explained on a couple of occasions in the past he soon reverts back to the 'quick in and out' method.

..as I see him inject on a daily basis I was wondering if there are any useful suggestions I could make (preferably on a casual basis) that will encourage him to follow the 10 second rule.
 
If he's been told how to do it correctly and he chooses not to, there's not much you can do to help him.
 
I was told to count to 10 so that the device has time to deliver the dose. With the short 4 or 5 mm needles there is no need to "pinch the skin". The reason for needing to pinch or to clutch the fat layer before injecting was recommended when using longer needles so as to not inject into muscle. Sometimes we hit a nerve and feel pain. Other times it just stings. Sometimes we hit a minute capillary and we bleed and bruise. A new needle for each injection is recommended because the sharp tip becomes blunted after continued use.

It must be very irritating for your partner to have you watching his technique. You are only seeing the visible part of his diabetic management regimen. You have no way of knowing how he actually feels from minute to minute. There is so much more to diabetes than just the injections. My recommendation to you is to leave him to deal with his injections his way as he does 24/7.
 
Ambersilva said:
I was told to count to 10 so that the device has time to deliver the dose. With the short 4 or 5 mm needles there is no need to "pinch the skin". The reason for needing to pinch or to clutch the fat layer before injecting was recommended when using longer needles so as to not inject into muscle. Sometimes we hit a nerve and feel pain. Other times it just stings. Sometimes we hit a minute capillary and we bleed and bruise. A new needle for each injection is recommended because the sharp tip becomes blunted after continued use.

It must be very irritating for your partner to have you watching his technique. You are only seeing the visible part of his diabetic management regimen. You have no way of knowing how he actually feels from minute to minute. There is so much more to diabetes than just the injections. My recommendation to you is to leave him to deal with his injections his way as he does 24/7.
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@Ambersilva ...Just to clarify the point about 'watching'......perhaps I should have used the term 'noticing'.....he takes his insulin as I am dishing up the dinner and I notice his technique....but make no comment.
I do leave him to get on with it but just wonder if he improved his technique it would help him to feel less despondent about the pain...and the correct amount of insulin would be delivered.
 
CatLadyNZ said:
If he's been told how to do it correctly and he chooses not to, there's not much you can do to help him.
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To be fair to OP, I've been told how to inject properly but I'm not 100% sure of why we count to 10 secs or what happens if we don't so the points are very valid and may/may not improve her partners diabetes management.
 
dannyw said:
To be fair to OP, I've been told how to inject properly but I'm not 100% sure of why we count to 10 secs or what happens if we don't so the points are very valid and may/may not improve her partners diabetes management.
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@dannyw ....that I think was my point....no one to my knowledge has explained 'why'....if he knew why and that it would improve his injection experience in terms of minimising pain or bleeding then he would feel more comfortable about the process.
 
It stops seepage from the injection site by allowing the insulin time to disperse.
 
A lot of diabetics will bruise or bleed a tiny bit when injecting into the tummy. A good alternative is to use the top of the arm as this hurts far less if at all and very rarely causes bleeding or bruising. The downside is that insulin will take a tiny bit longer to work but there's not a lot of difference and it enables people to be happier and keeps tummy ok incase of wanting a pump and finding that a degree of pen needle scar tissue has built up and poses problems with infusion sets delivering insulin ok.
 
CatLadyNZ said:
If he's been told how to do it correctly and he chooses not to, there's not much you can do to help him.
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@CatLadyNZ,
That comment is a bit unfeeling and not in the spirit of the forum IMHO.
The OP's partner MAY of been told of the correct procedure, but this may have not been corectly expained or his understanding of the procedure checked. It is only concern for our fellow man that makes us provide backup info to be gently fed to him when wanted!
 
Hi @Molly56

I am assuming your partner uses a modern pen?
The mechanism in these devices have a "smoother action" regarding insulin delivery these days.

But, if one was to do an "airshot" of (for instance) 10 units? (An airshot of 2u is always done prior to injection to prime the needle & expell any trapped air.)
The stream of insulin will fire into the air, and as the insulin jet drops off when the plunger in the barrel pushing the bung comes to rest. You should then see a couple of droplets emerge from the end of the needle..? There may be a split second delay in this action.
So the ten second rule is to allow "absorption" as mentioned by my good fellow injectors earlier. Thus ensuring the correct dose....
 
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Jaylee said:
Hi @Molly56

I am assuming your partner uses a modern pen?
The mechanism in these devices have a "smoother action" regarding insulin delivery these days.

But, if one was to do an "airshot" of (for instance) 10 units? (An airshot of 2 is always done prior to injection to prime the needle & expell any trapped air.)
The stream of insulin will fire into the air, and as the insulin jet drops off when the plunger in the barrel pushing the bung comes to rest. You should then see a couple of droplets emerge from the end of the needle..? There may be a split second delay in this action.
So the ten second rule is to allow "absorption" as mentioned by my good fellow injectors earlier. Thus ensuring the correct dose....
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@Jaylee ...thanks for comments....this raises another issue about injection technique....my partner never (and I mean, never) does the 2 unit airshot before dialling up dose and injecting....just wondered how much this matters ....could air in the needle potentially cause pain or discomfort when injecting or affect absorption of insulin...
 
I am on a mixed insulin Humulin M3. As I have large doses of 52 units am and 36 pm I do a 20 second count for absorption.
 
Molly56 said:
@Jaylee ...thanks for comments....this raises another issue about injection technique....my partner never (and I mean, never) does the 2 unit airshot before dialling up dose and injecting....just wondered how much this matters ....could air in the needle potentially cause pain or discomfort when injecting or affect absorption of insulin...
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I always do an airshot. It is advised.. (But I have been injecting for 39 years.) Keep the pen with the needle pointing vertically upwards. A short flick or light tap on the side of the cartridge chamber to loosen any bubbles to the top. Then dial a couple of units & expel to ensure the needle is primed.. Any air injected could cause discomfort & possibly push any insulin back out I suppose??
 
Jaylee said:
Hi @Administrator ,

Can I be a little bit forward in asking if this thread can be merged with the topic in the link attached by the same OP, covering pretty much the same issue.. I feel this action would help the OP acumilate the advice given a little more efficiently.. :cool:

Many thanks! The link http://www.diabetes.co.uk/forum/threads/problems-when-injecting-type-2-on-insulin.81764/
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@Jaylee @Administrator ...I would have asked the question in the original thread if I had been able to edit the thread title slightly to pose the question about the 10 second rule....
..in the past I seem to remember that there was an option to 'edit thread title' but this doesn't seem to exist anymore (unless I am missing it somewhere)....hence my decision to start this new thread but refer it back to my original question....
...apologies if this has caused any unnecessary confusion or duplication.......:sorry:
 
Molly56 said:
@Jaylee @Administrator ...I would have asked the question in the original thread if I had been able to edit the thread title slightly to pose the question about the 10 second rule....
..in the past I seem to remember that there was an option to 'edit thread title' but this doesn't seem to exist anymore (unless I am missing it somewhere)....hence my decision to start this new thread but refer it back to my original question....
...apologies if this has caused any unnecessary confusion or duplication.......:sorry:
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Not to worry @Molly56
I'm concerned @himtoo & @Shar67 's valued input on the other thread is being left behind.. ;)

Though I do feel there is a danger of derailing both your threads by splitting separate aspects of what is essentially the same topic.
It is your partner's injecting technique under discussion after all..! :)
 
I think an air shot is important to show that the insulin is flowing properly from the pen/needle. Every now and then I do an air shot and nothing cones out - I think this is usually where the fine needle has bent while being screwed on. Without an airshot I would not know this had happened.
 
all aspects of injections are important and I agree with @Jaylee about merging on this.

The rotation of sites , airshots , 10 second rule , insulin storage just to name a few all play their part in helping to maintain good control over the years.

all the best !
 
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