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Do I Have To Take Insulin For Type 2 Diabetes

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What Are The 6 Different Types Of Insulin

Insulin Treatment in Patients with Type 2 Diabetes

If you need insulin, your doctor will recommend a specific type depending on your lifestyle, the type of diabetes you have, and your blood sugar levels at different times of the day. You may need more insulin coverage at mealtimes, overnight, or throughout the entire day. Currently, there are 5 types of injectable insulins and 1 inhaled insulin.

Types of insulin and how they work in your body

How long it takes to start working How long it lasts

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What Problems Can Happen With Type 2 Diabetes

Not having the right amount of sugar in the blood can lead to:

  • hyperglycemia.This is when blood sugars are too high. Someone with hyperglycemia may be extra thirsty and pee more than usual. If high blood sugars arent treated, they can get very sick and have health issues later in life, like heart and kidney problems.
  • diabetic ketoacidosis . This serious condition needs treatment right away. When theres not enough insulin in the body to let the glucose into the cells, the body starts to break down fat instead of sugar. Symptoms of DKA can include nausea, vomiting, belly pain, fast breathing, and in severe cases, unconsciousness. DKA happens more often in people with type 1 diabetes, but it can sometimes happen to those with type 2 diabetes.
  • hyperglycemic hyperosmolar state . Like DKA, this is a serious condition that needs treatment right away. People with HHS have severe dehydration and very high blood sugars.
  • hypoglycemia. This is when blood sugars are too low. It can sometimes happen when people with type 2 diabetes are treated with insulin. If a person with diabetes gets more insulin than they need, their blood sugar level can drop too low. Symptoms can include headache, weakness, shakiness, anxiety, and sweating.

What Oral Medicines Treat Type 2 Diabetes

You may need to take medicines to manage your type 2 diabetes, in addition to consuming healthy foods and beverages and being physically active. You can take many diabetes medicines by mouth. These medicines are called oral medicines.

Most people with type 2 diabetes start with metformin pills. Metformin also comes as a liquid. Metformin helps your liver make less glucose and helps your body use insulin better. This drug may help you lose a small amount of weight.

Other oral medicines act in different ways to lower blood glucose levels. Combining two or three kinds of diabetes medicines can lower blood glucose levels better than taking just one medicine.

Read about different kinds of diabetes medicines from the FDA.

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Do You Have Insulin Resistance

How do you find out if youre insulin resistant? No one test will tell you, but if you have high blood sugar levels, high triglycerides , high LDL cholesterol, and low HDL cholesterol, your health care provider may determine you have insulin resistance.

Important note: Type 1 diabetes is different its thought to be caused by an autoimmune reaction . People with type 1 diabetes dont make enough insulin and need to take it to survive.

Newly Diagnosed With Type 2 Diabetes

Is Type 2 Diabetes Curable? (8 Things You Should Know)

Knowing where to get started following a type 2 diagnosis can be a challenge. You may feel overwhelmed, but its important to know there isnt a one-size fits all approach to managing the condition.

As well as using the information on this page to understand your condition, you can meet other people with type 2 diabetes in our Learning Zone. Youll hear advice from others in your position, and get practical tools to help you feel more confident managing your condition.

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Reasons To Continue Insulin

Although none of these four drug classes cause hypoglycemia, they all have potential side effects and risks to consider. And since beauty and the risk/benefit ratio of any treatment is ultimately in the eye of the beholder, one can reasonably decide to continue with insulin despite deteriorating health or advancing age .

In particular, some people with Type 2 diabetes no longer produce any insulin on their own, and it may be hard to obtain even reasonable blood sugar control without it. And although hypoglycemia is rightly feared, significant and persistent blood sugar elevations are not completely harmless. They can cause dehydration, fatigue, vision change and slow wound healing and increase infection risk.

If older patients do continue with insulin, its common practice to stick with a daily, long acting insulin. These carry a lower of risk of hypoglycemia compared to shorter acting insulins, which are designed to quickly capture the carbohydrate load of a meal.

Like a turtle, a diamond cutter or Father Time playing the back nine, slow and smooth wins the day.

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How Is Type 2 Diabetes Managed

Theres no cure for Type 2 diabetes. But you can manage the condition by maintaining a healthy lifestyle and taking medication if needed. Work with your healthcare provider to manage your:

  • Blood sugar: A blood glucose meter or continuous glucose monitoring can help you meet your blood sugar target. Your healthcare provider may also recommend regular A1c tests, oral medications , insulin therapy or injectable non-insulin diabetes medications.
  • Blood pressure: Lower your blood pressure by not smoking, exercising regularly and eating a healthy diet. Your healthcare provider may recommend blood pressure medication such as beta blockers or ACE inhibitors.
  • Cholesterol: Follow a meal plan low in saturated fats, trans fat, salt and sugar. Your healthcare provider may recommend statins, which are a type of drug to lower cholesterol.

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Disposal Of Used Insulin Syringes

Used syringes, pen needles, cannulas and lancets must be disposed of in an Australian Standards-approved sharps container, which is puncture-proof and has a secure lid. These containers are usually yellow and are available through pharmacies, local municipal councils and state or territory diabetes organisations such as Diabetes Victoria.

Procedures to dispose of sharps containers vary from state to state.

For sharps disposal information and help, you can contact:

  • state or territory diabetes organisations, such as Diabetes Victoria
  • state Department of Health

Insulin needs to be stored correctly. This includes:

  • Store unopened insulin on its side in a fridge.
  • Keep the fridge temperature between 2 and 8 °C.
  • Make sure that insulin does not freeze.
  • Once opened, keep it at room temperature for not more than one month and then dispose of it safely.
  • Avoid keeping insulin in direct sunlight.

Extreme temperatures can damage insulin so it doesn’t work properly. It must not be left where temperatures are over 30 °C. In summer your car can get this hot so don’t leave your insulin there.

There are various insulated insulin carry bags available for transporting insulin.

How Do I Calculate How Much Insulin To Take

Starting Insulin Early For Type 2 Diabetes

In people who do not have diabetes, their bodies release insulin in response to the foods they eat. This is because many foods contain carbohydrates. Some examples include bread, sweets, fruits, and even vegetables.

Your body breaks carbohydrates down into smaller building blocks, like glucose. You need insulin to use this glucose for energy. If your body cannot make or use insulin effectively, youll need to inject it to process your food for energy.

Calculating how much insulin to take is usually based on two considerations:

  • Basal insulin dose. A basal insulin dose is an amount that you give yourself daily regardless of the foods you eat.
  • Bolus insulin dose. A bolus insulin dose helps correct or anticipate the carbohydrates you eat throughout the day. You will usually correct this with a bolus dose of rapid-acting insulin.

Anticipating a bolus dose is where insulin administration can get tricky. When you give yourself insulin, you are estimating how many units of insulin it will take to process the carbohydrates you eat.

The University of California, San Francisco states that, as a general rule, 1 unit of insulin will process anywhere from 12 to 15 grams of carbohydrates and lower your blood sugar by about 50 milligrams per deciliter .

Since the human body is so complex, not all people will process insulin the same way. Factors like time of day, stress levels, and physical activity can make these numbers more difficult to predict.

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Why Do Some People Get Type 2 Diabetes

No one knows for sure why some people get type 2 diabetes, but its likely a combination of genes and the environment. Many teens who get it have someone in their family who has it too.

Type 2 diabetes happens more often in people:

  • who are overweight. When a person has extra weight, sugar in the blood doesnt get into the cells as well as it should. But people dont have to be overweight to get type 2 diabetes.
  • during puberty. Many kids and teens are diagnosed with type 2 diabetes around puberty. As growth hormone levels normally rise during puberty, insulin does not work as well.
  • with polycystic ovary syndrome . Girls and women with PCOS have insulin resistance and are more likely to get type 2 diabetes.
  • whose mothers had diabetes during pregnancy. Babies are exposed to more sugar in the womb when their mother has diabetes. This along with genetic factors increase the chance of getting type 2 diabetes later in life.

Do Check Your Blood Sugar Regularly And Write Down Each Measurement

Your insulin treatment involves much more than injecting insulin. You need to check your blood sugar level regularly using a blood glucose monitor. The constant need to test your blood sugar can feel like a burden, but its a crucial part of your diabetes care plan.

Blood sugar measurements can change depending on your stress level, how much exercise youre getting, illness, changes in your diet, and even hormonal changes during the month. Major changes could mean that you have to adjust your insulin dose.

Write down each measurement or record it in an app on your phone to show to your doctor. Your doctor needs this information to determine how much insulin is right for you.

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What Should I Know About Side Effects Of Diabetes Medicines

Side effects are problems that result from taking a medicine. Some diabetes medicines can cause hypoglycemia, also called low blood glucose, if you dont balance your medicines with food and activity.

Ask your doctor whether your diabetes medicine can cause hypoglycemia or other side effects, such as upset stomach and weight gain. Aim to take your diabetes medicines as your doctor instructs you, to help prevent side effects and diabetes problems.

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Diabetes can be managed through oral medications. In addition to insulin, metformin, which is a sugar-reducing agent, is also a common treatment for diabetes. It is considered a first-line therapy for diabetes treatment and is often added to insulin. It is important to know the risks of taking diabetes medications. Some drugs can be addictive, so you must consult your doctor before taking any medication. Your physician can prescribe you an appropriate treatment plan based on your medical history.

Your doctor will prescribe medication and check your blood glucose levels on a regular basis. Your A1c level will be checked every six months and your cholesterol levels will be tested regularly. Your doctor will also look for any signs of retinopathy, which is damage to the nerves in the eye caused by diabetes. You will also be examined for any foot problems. It is important to see a foot specialist regularly. Your feet should be thoroughly inspected for damage to the nerves.

While the first two types of insulin are the most common treatments, diabetes can be treated in a variety of ways. Your doctor may prescribe medications to control high blood pressure, which can protect the kidneys. Other types of medication include aspirin and other types of anti-platelet drugs. If your doctor is concerned about your blood sugar level, you may need to try a different medication. Some medications can cause side effects. Your treatment will depend on what type of insulin you need.

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Insulin For Type 2 Diabetes

If you have type 2 diabetes and your doctor thinks insulin can help you, it doesnt mean you now have type 1 diabetes. You still have type 2 diabetes, but youve changed treatment.

If you have type 2 diabetes, you may not need to use insulin straight away. But some people have very high blood sugar levels when they are first diagnosed. Insulin can be used as a short-term treatment to help quickly bring down your blood sugar levels.

Some people may need to take insulin for a particular reason, like during pregnancy or a severe illness, or after surgery. But you may also need to start it as a treatment if other medications havent helped managed your blood sugar levels or are not appropriate for you.

If you need insulin it isnt your fault and it doesnt mean you havent managed your diabetes well. Its simply another medication that can help to keep you as healthy as possible. Managing blood sugars effectively is really important in reducing your risk of future diabetes complications and insulin may be the most appropriate treatment choice for you. Many people with type 2 diabetes need to use it as treatment at some point.

Its still important to keep going to your appointments and manage your condition with healthy lifestyle choices. Staying active and eating a healthy diet will reduce the risk of complications from your diabetes.

If youre going on holiday:

Page last reviewed: 18 August 2020 Next review due: 18 August 2023

When Should Insulin Therapy Be Initiated

Type 2 diabetes is a progressive disease, and thus, ultimately this question will arise for many of our patients. Unfortunately, there is no unequivocal answer, which was nicely illustrated by a recent interactive case vignette. The polling results demonstrated once again that the management of patients with type 2 diabetes uncontrolled by two oral glucose-lowering agents is controversial. Furthermore, the preferred treatment option was found to be related to the respondents locations and self-reported specialties .

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Putting It All Together

Now that you know the how and why behind insulin dosing, lets consider how you may calculate your insulin needs.

Youll usually give yourself an insulin dose around your meals since thats when you take in carbohydrates. You also will typically check your blood sugar to see if youre meeting your premeal target dose.

To calculate your insulin needs:

  • Check your blood sugar level before a meal.
  • If your blood sugar level is in your target range, you do not need to calculate for extra insulin.
  • If your blood sugar level is higher than your target range , calculate how much insulin youll need. You should talk with your doctor about this, but usually, 1 unit will bring your levels down by 50 points.
  • Calculate the number of carbohydrates youre about to eat. You can usually estimate these using carbohydrate counters.
  • For every 10 grams of carbohydrates, give yourself 1 unit of insulin. Ask your doctor if this number may be different for you.
  • Add the number of units needed to adjust for both your target range and meal.
  • Administer the total units of insulin.
  • You may find that if you generally eat about the same amount of carbohydrates each day, you may be able to consistently inject the same amounts of insulin outside of special occasions. It takes time to find out how your body best responds to insulin.

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    How Much Insulin Should I Take For Low Blood Sugar

    Insulin will lower your blood sugar. If your blood sugar is already low, you shouldnt inject more insulin.

    Signs that your blood sugar is too low include sweating, dizziness, blurred vision, and significant fatigue. If this happens, try to consume rapid-acting carbohydrates, like sugared sodas, fruit juice, or glucose tablets, to get your blood sugar levels back up quickly.

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