Insulin Blood Sugar And Type 2 Diabetes
Insulin is a key player in developing type 2 diabetes. This vital hormoneyou cant survive without itregulates blood sugar in the body, a very complicated process. Here are the high points:
- The food you eat is broken down into blood sugar.
- Blood sugar enters your bloodstream, which signals the pancreas to release insulin.
- Insulin helps blood sugar enter the bodys cells so it can be used for energy.
- Insulin also signals the liver to store blood sugar for later use.
- Blood sugar enters cells, and levels in the bloodstream decrease, signaling insulin to decrease too.
- Lower insulin levels alert the liver to release stored blood sugar so energy is always available, even if you havent eaten for a while.
Thats when everything works smoothly. But this finely tuned system can quickly get out of whack, as follows:
- A lot of blood sugar enters the bloodstream.
- The pancreas pumps out more insulin to get blood sugar into cells.
- Over time, cells stop responding to all that insulintheyve become insulin resistant.
- The pancreas keeps making more insulin to try to make cells respond.
- Eventually, the pancreas cant keep up, and blood sugar keeps rising.
Some Options Are More Affordable
Some brands of insulin and types of delivery devices are less expensive than others. For example, syringes tend to cost less than insulin pumps.
If you have health insurance, contact your provider to learn what types of insulin and delivery devices are covered. If your current insulin regimen is too expensive, talk to your doctor to learn if there are more affordable options.
In some cases, you might develop side effects from insulin, such as:
- low blood sugar
- pain or discomfort at the injection site
- infection at the injection site
- in rare cases, an allergic reaction at the injection site
Low blood sugar, or hypoglycemia, is one of the most serious potential side effects from taking insulin. If you start taking insulin, your doctor will talk to you about what to do if you experience low blood sugar.
If you experience any side effects from taking insulin, let your doctor know.
The Goal Of Insulin Is To Mimic The Pancreas
If you do need insulin, your healthcare provider may prescribe one of five primary typesrapid-acting, regular or short-acting, intermediate-acting, long-acting, or ultra long-acting. These vary in how quickly or slowly they reach the bloodstream , the amount of time they work at maximum strength , and how long they continue to be effective .
The different types of insulin work to mimic the natural rhythm of a healthy pancreas, which produces a consistently low level of insulin as well as occasional bursts to cope with post-meal surges in blood sugar.
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What Is Type 2 Diabetes
Type 2 diabetes is a disease where your body cant use energy from food properly. Your pancreas produces insulin to help your cells use glucose . But over time your pancreas makes less insulin and the cells resist the insulin. This causes too much sugar to build up in your blood. High blood sugar levels from Type 2 diabetes can lead to serious health problems including heart disease, stroke or death.
Avoiding Injection Bruises And Lumps
Bruising can happen when you catch a tiny blood vessel under the skin where you have injected. It is quite normal for this to happen occasionally when you are injecting regularly and youre not doing anything wrong.
If you are concerned, you could make an appointment with your diabetes specialist nurse who will be able to do a review of your injection technique. In some cases, bleeding and bruising can be reduced by something as simple as using a different sized needle or changing your needle after each injection.
Some people notice hard lumps that can form if you inject in the same place too often. This might be lipohypertrophy , or could be something called cutaneous amyloidosis. These lumps can stop the insulin from working properly, so make sure you rotate where you inject and choose a different spot each time. If you notice any lumps, especially if they’re not going away, speak to your healthcare professional for more advice.
Other side effects from injecting a lot can be itching, rashes and other skin irritations. Changing where you inject helps with this too. You can also get treatments from your local pharmacy that can will help with the irritation.
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How Protein And Fats Affect Carb Counting And Insulin Dosing
It is also important to know that although proteins and fats do not have a direct effect on carbohydrates, they do affect the way carbohydrates are absorbed. A food that contains carbohydrates in addition to a high protein or fat content will be absorbed more slowly but the effect will be longer, that is, it will not generate such a high glucose peak but it will last longer. You may need to adjust your ratios as you learn how various meals impact you.
Other Types Of Insulin Are Injected
Other than one type of inhalable insulin, all other types of insulin are given by injection. Intermediate-and long-acting insulin can only be injected. Insulin cant be taken in pill form because your digestive enzymes would break it down before it could be used in your body.
Insulin should be injected into the fat just below your skin. You can inject it into the fat of your abdomen, thighs, buttocks, or upper arms.
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Your Treatment Needs Can Change
Over time, your condition and treatment needs can change. If youve found it difficult to manage your blood sugar with lifestyle changes and other medications, your doctor might prescribe insulin. Following their recommended treatment plan can help you manage your condition and lower your risk of complications.
Things To Remember In Order To Change Insulin Doses:
- If the pattern happens at the blood sugar check before breakfast, change the long-acting insulin dose by 10 percent.
- If the pattern happens at the blood sugar check before lunch, change the breakfast rapid-acting insulin dose by 10 percent.
- If the pattern happens at the blood sugar check 2 to 3 hours after lunch, change the lunch rapid-acting insulin dose by 10 percent.
- If the pattern happens at the blood sugar check 2 to 3 hours after supper , change the supper rapid-acting insulin dose by 10 percent.
- If your blood sugar is above 180 two to three hours after a meal, ask yourself what caused this.
- Common reasons for high blood sugar 2 to 3 hours after eating are:
- Not taking insulin at least 15 minutes before eating
- Eating too much carbohydrate or too much quick-acting carbohydrate
- Not taking enough insulin to cover the carbohydrate
- Not eating protein or fat in your meal
- Eating a very high fat meal
If you rule out numbers 1 and 2, you may need to take more insulin next time.
- If the pattern is high blood sugar, you will increase the insulin dose that affects that column of blood sugars.
- If the pattern is low blood sugar, you will decrease the insulin dose that affects that column of blood sugars.
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Myths About Insulin And Type 2 Diabetes
When you hear the word insulin, do you picture giant needles or pop culture portrayals of insulin users with low blood sugar ?Either way, most people think of insulin as a difficult, painful, or potentially scary medical treatment.The problem is that if you have type 2 diabetes, you need to know the real deal before you can make an informed choice about whether or not this potentially lifesaving therapy is right for you.Here, we take a look at the facts and fiction about insulin when it comes to treating type 2 diabetes.
Learn How To Inject Insulin
Insulin can be injected using a syringe, but most people use insulin pens. Insulin pens are similar in size and shape to a writing pen. They make measuring and injecting your insulin easier and are easy to carry around. Insulin pens are not pre-fitted with needles. A suitably sized needle has to be attached to the pen. Insulin should be injected into the fatty tissue under your skin. Your abdomen or tummy area, about 5 cm away from your belly button, is usually a good place. It is easy to reach and insulin absorbs well from this site. Read more about how to inject insulin.
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Guidelines For Starting Insulin
Know your health care providerâs plan up front. Ask what A1C and blood glucose measures are used and how you will start taking insulin.
Think short-term, not long-term. Start taking insulin when your health care provider recommends it, and notice if you feel better and have more energy. Donât try to put it off from appointment to appointment.
Ask to be referred to a diabetes education program to learn the ins and outs of taking insulin and get the support you need.
Have a plan with your health care provider to be in touch regularly to increase your dose until you hit your blood glucose targets.
Get the inside scoop from people who have successfully transitioned to insulin. Try attending a support group or connecting with people willing to support you in one or more of the diabetes online communities.
Explore your options for insulin delivery â using the traditional vial and syringe, or using the more contemporary and convenient pens or possibly an insulin pump. Check your health insurance plan to see what it covers.
Continue to eat well and exercise regularly.
Strive for consistency. Take your insulin and eat at similar times every day when possible.
Store insulin properly. Keep the pen or vial of insulin at room temperature , and store extras in the refrigerator.
Carry a source of carbohydrate to treat low blood sugar, such as glucose tablets or hard candy. Start by using 15 grams of carbohydrate.
When Should Insulin Be Started
Q. Will my patient with type 2 diabetes require insulin?
A. It varies from patient to patient. However, type 2 diabetes is a progressive disease marked by gradual loss of beta cell function and most patients will eventually require insulin therapy.1 This should be viewed as part of the pathophysiology of the disease and not as a failure on the part of the patient or healthcare provider.
Insulin should be discussed early with patients who are beginning to show progression of their diabetes to ease the transition when the time to start insulin therapy arrives. This time should be considered part of a larger conversation between provider and patient, and not seen as a turning point down a path to the many severe complications of diabetes.
Q.Is there a specific hemoglobin A1c at which insulin must be started?
A. No. Insulin, like all treatments for diabetes, should be started and adjusted to achieve a reasonable goal HbA1c for the patient. The American Diabetes Association previously recommended that a patients HbA1c not be allowed to exceed 8%, creating an action point for escalation of therapy.
Insulin therapy will often need to be started if the initial fasting plasma glucose is greater than 250 or the HbA1c is greater than 10%.4_________________________________________________________________________________________________________________________________________________________________________________________________________________
References:
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You Can Use Different Delivery Devices
To inject insulin, you can use any of the following delivery devices:
- Syringe. This empty tube attached to a needle can be used to draw a dose of insulin from a bottle and inject it into your body.
- Insulin pen. This injectable device contains a premeasured amount of insulin or cartridge filled with insulin. The individual dose can be dialed up.
- Insulin pump. This automated device delivers small and frequent doses of insulin into your body, through a catheter placed under your skin.
You can talk to your doctor about the pros and cons of different delivery methods for your medication.
Practicing healthy habits can potentially delay or prevent your need for insulin therapy. If youve already started insulin therapy, adjusting your lifestyle might help reduce the amount of insulin you need to take.
For example, it might help to:
Insulin Therapy Can Help Lower Your Blood Sugar
If you have type 2 diabetes, managing your blood sugar levels is a key part of staying healthy and reducing your risk of long-term complications. To help lower your blood sugar, your doctor might recommend one or more of the following:
- lifestyle changes
- insulin therapy
- weight loss surgery
Insulin therapy can help many people with type 2 diabetes manage their blood sugar and reduce their risk of complications.
Several types of insulin are available. They broadly fall into two categories:
- fast/short acting insulin used for meal time coverage
- slow/long-acting insulin, which is active between meals and overnight
There are several different types and brands available in each of these two categories. Premixed insulins are also available, which include both kinds of insulin. Not everyone needs both kinds, and a prescription for insulin should be individualized for the persons needs.
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How Do I Take And Adjust My Insulin Doses
It is important to learn the different methods of taking insulin and what kinds of insulin can be delivered through each method. There are several ways to take insulin syringe, pen, pump, or inhalation though injection with a syringe is currently the most common for people with type 2 diabetes. There are many apps that can help you calculate your insulin doses.
Your insulin regimen should be tailored to fit your needs and lifestyle. Adjusting your basal insulin dosage and timing will require conversations and frequent follow-up with your healthcare team. When initiating insulin therapy, you may be advised to start with a low dose and increase the dose in small amounts once or twice a week, based on your fasting glucose levels. People with diabetes should aim to spend as much time as possible with glucose levels between 70-180 mg/dl. Insulin may be used alone or in combination with oral glucose-lowering medications, such as metformin, SGLT-2 inhibitors, or GLP-1 agonists.
One of the most important things to consider is the characteristics of different insulin types. To learn more, read Introducing the Many Types of Insulin Is There a Better Option for You? and discuss with your healthcare team.
In order to dose insulin to cover meals or snacks, you have to take a few factors into consideration. Your healthcare team should help you determine what to consider when calculating an insulin dose. Prandial insulin doses will usually be adjusted based on:
When Should Insulin Therapy Be Intensified
Because of progressive -cell decline, treatment with once-daily basal insulin alone will eventually fail to maintain glycemic control in a substantial number of patients with type 2 diabetes. When the recommended A1C level of < 7.0% is not reached, or maintained despite successful basal insulin dose titration maintaining fasting plasma glucose 100 mg/dl, or when aggressive titration is limited by hypoglycemia, treatment should be intensified by adding insulin injections.
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How To Get Free Prescriptions For Diabetes Medicine
Youâre entitled to free prescriptions for your diabetes medicine.
To claim your free prescriptions, youâll need to apply for an exemption certificate. This is known as a PF57 form. To do this:
- fill in a form at your GP surgery
- you should get the certificate in the post about a week later itâll last for 5 years
- take it to your pharmacy with your prescriptions
Save your receipts if you have to pay for diabetes medicine before you receive your exemption certificate. You can claim the money back if you include the receipts along with your completed PF57 form.
If Not Controlled At The Right Time Diabetes Can Lead To Kidney Failure Partial Or Complete Blindness Nerve Problems Loss Of Limbs And Increase The Risk Of A Heart Attack
Insulin, which is produced by the pancreas in the body, helps control the bodys blood sugar level. Regular insulin intake along with a proper diet and exercise plan is recommended for type 2 diabetes patients to help maintain their blood sugar level. If not controlled at the right time, diabetes can lead to kidney failure, partial or complete blindness, nerve problems, loss of limbs and even increase the risk of a heart attack. However, there are several myths around injecting insulin due to lack of awareness.
A study, published in the American Medical Associations biomedical journal JAMA Network Open, also found that the relative risk of death due to diabetes itself was much stronger among individuals who were underweight. The findings suggest that there is an urgent need to develop diabetes management programs that are tailored to Asian populations and the subsequent strong implementation of these programs in Asia.
Why do Type 2 diabetics need insulin?
The pancreas, that produces digestive enzymes, is also responsible for producing insulin, a hormone that helps regulate blood sugar levels. Insulin helps the body use the carbohydrates in food for energy. If a patient develops Type 2 diabetes, their pancreas stop producing sufficient insulin that is required for the body to control blood sugar level, said Dr Roopak Wadhwa, consultant, department of diabetes endocrinology and metabolism at Fortis Hospital.
Tips while taking insulin injections
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Why Do I Need To Take Insulin
All people who have type 1 diabetes and some people who have type 2 diabetes need to take insulin to help control their blood sugar levels. The goal of taking insulin is to keep your blood sugar level in a normal range as much as possible. Keeping blood sugar in check helps you stay healthy. Insulin cant be taken by mouth. It is usually taken by injection . It can also be taken using an insulin pen or an insulin pump.