Who Needs To Take Insulin
Diabetes impairs insulin production by the pancreas and use of this essential hormone by the body. The condition causes high blood sugar levels.
However, not every person with type 2 diabetes will need to take insulin. People with type 1, on the other hand, will have to supplement their insulin supply for the rest of their lives.
There are three main types of diabetes:
- Type 1 diabetes: Typically starts in childhood when a person does not produce enough insulin. Usually results from the bodys immune system attacking an otherwise healthy pancreas.
- Type 2 diabetes: Can develop at any age but 45 years is the average age of onset. Either the pancreas does not produce enough insulin, or the bodys cells become resistant to its actions.
- Gestational diabetes: Occurs during pregnancy and makes it harder for a womans body to respond to insulin. Typically stops after childbirth but increases a womans risk of developing type 2 diabetes.
Type 1 and type 2 diabetes are usually lifelong conditions. According to the Centers for Disease Control and Prevention , more than 30 million people in the United States have diabetes. Type 2 diabetes is the most common, accounting for
What Are The Different Types Of Insulin
Several types of insulin are available. Each type starts to work at a different speed, known as onset, and its effects last a different length of time, known as duration. Most types of insulin reach a peak, which is when they have the strongest effect. After the peak, the effects of the insulin wear off over the next few hours or so. Table 1 lists the different types of insulin, how fast they start to work, when they peak, and how long they last.
Table 1. Types of insulin and how they work1,2
|does not peak||36 hours or longer|
Another type of insulin, called premixed insulin, is a combination of insulins listed in Table 1. Premixed insulin starts to work in 15 to 60 minutes and can last from 10 to 16 hours. The peak time varies depending on which insulins are mixed.
Your doctor will work with you to review your medication options. Talk with your doctor about your activity level, what you eat and drink, how well you manage your blood glucose levels, your age and lifestyle, and how long your body takes to absorb insulin.
Follow your doctors advice on when and how to take your insulin. If you’re worried about the cost, talk with your doctor. Some types of insulin cost more than others. You can also find resources to get financial help for diabetes care.
Rotate Your Injection Sites
Anywhere you can pinch a bit of skin is a place you can inject insulin, says Dr. Donner. The most common spots include the abdomen, thighs, upper hip area, and the back of the arms. Be sure to rotate between a few different locations on your body, he adds. If you hit the same spot repeatedly, you can get fatty deposits under the skin at the injection site that may interfere with the absorption of the insulin. This condition is called insulin lipohypertrophy, he explains, and can affect blood sugar levels if youre not absorbing the proper dose of insulin.
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You’ve Heard That Insulin Causes Blindness And Kidney Failure
Nothing could be further from the truth. High blood glucose cause blindness, kidney failure, and other problems, such as nerve damage that can lead to amputations. But eye, kidney, and nerve damage can be delayed or prevented by good control. Insulin will NOT make your diabetes worse, and it is one of the most natural diabetes treatments available.
Insulin Medicines & Other Diabetes Treatments
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Taking insulin or other diabetes medicines is often part of treating diabetes. In addition to making healthy food and beverage choices, getting physical activity, getting enough sleep, and managing stress, medicines can help you manage the disease. Some other treatment options are also available.
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How Do You Take Insulin Without A Syringe
There are several options:
Insulin pens look like large writing pens and can help prevent under- and overdosing. They also dont require refrigeration, are conveniently prefilled, and are more durable than syringes.
Insulin pumps are attached to a thin tube thats implanted under your skin. Pumps are computerized or motorized, and some models also act as glucose monitors. They deliver insulin before each meal along with small amounts through the course of the day. In the US, about 60% of people with diabetes use some form of .
Jet injection devices are a good option if you hate needles. A jet injector holds several doses of insulin. After placing it against your skin, you press a button, and the insulin is pushed through.
Inhaled insulin comes in a pre-measured inhaler and was first approved in 2014. Its short-acting and usually not covered by insurance, which makes it more cost prohibitive than other types of insulin for most people with diabetes.
Unless you have an insulin pump that also works as a glucose monitor, insulin dosing is based on self-monitoring your blood glucose levels. You can check them by doing finger pricks or wearing a device that continuously monitors them for you.
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Basal insulin. Small amounts of insulin are released by the pancreas 24 hours a day. On average, adults secrete about one unit of insulin per hour regardless of food intake.
Bolus insulin. In response to food, larger amounts of insulin are secreted and released in two-phase boluses. The first phase starts within minutes of the first bite of food and lasts about 15 minutes. The second phase of insulin release is more gradual and occurs over the next hour and a half to three hours. The amount of insulin that is released matches the rise in blood glucose from the food that is eaten.
In people with normal insulin secretion, insulin production and release is a finely tuned feedback system that maintains blood glucose between about 70 mg/dl and 140 mg/dl at all times, no matter what or when a person eats or when he engages in physical activity. During illness, when insulin needs may rise, the pancreas just produces more.
People whose pancreas does not secrete insulin normally often must inject insulin or infuse it with an insulin pump. People who have Type 1 diabetes, in which the pancreas secretes no insulin or virtually no insulin, must inject or infuse insulin. But learning when to take insulin and how much to take is challenging, because injected or infused insulin does not act exactly like insulin released from the pancreas. The first step to figuring out when to take insulin and how much to take is understanding an insulins action curve.
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What Are The Types Of Insulin Glulisine
Insulin glulisine is available under the brand name Apidra®. The medicine comes in liquid form. To get insulin into your bloodstream you can:
- American Diabetes Association. Insulin Basics. Accessed 10/19/2021.
- U.S. National Library of Medicine. Apridra Insulin Glulisine Injection, Solution. Apridra SoloSTAR Insulin Glulisine Injection, Solution. Accessed 10/19/2021.
- Donner T, Sarkar S. Insulin Pharmacology, Therapeutic Regimens, and Principles of Intensive Insulin Therapy. . In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext . South Dartmouth : MDText.com, Inc. 2000. Accessed 10/19/2021.
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Table Of Insulin Actions
The table gives a guide as to quickly the insulins start to act, between which times they peak and how long their activity lasts for.
The speed at which insulin acts may vary in different people and where you inject can have a significant effect too, so the table should only be used as a rough guide to understand how insulin action times can vary.
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Diabetes Sick Day Rules
If you need to take insulin to control your diabetes, you should have received instructions about looking after yourself when you’re ill known as your “sick day rules”.
Contact your diabetes care team or GP for advice if you haven’t received these.
The advice you’re given will be specific to you, but some general measures that your sick day rules may include could be to:
- keep taking your insulin it’s very important not to stop treatment when you’re ill your treatment plan may state whether you need to temporarily increase your dose
- test your blood glucose level more often than usual most people are advised to check the level at least four times a day
- keep yourself well hydrated make sure you drink plenty of sugar-free drinks
- keep eating eat solid food if you feel well enough to, or liquid carbohydrates such as milk, soup and yoghurt if this is easier
- check your ketone levels if your blood glucose level is high
Seek advice from your diabetes care team or GP if your blood glucose or ketone level remains high after taking insulin, if:
- you’re not sure whether to make any changes to your treatment
- you develop symptoms of diabetic ketoacidosis
- you have any other concerns
Read more about sick day rules
Diabetics Need Insulin Therapy Because They Can’t Make Their Own
Insulin therapy tries to mimic natural insulin secretion what happens automatically in non-diabetics.
The ultimate goal of insulin therapy is to mimic normal insulin levels. Unfortunately, current insulin replacement therapy can only approximate normal insulin levels. Insulin therapy for type 2 diabetes ranges from one injection a day to multiple injections and using an insulin pump . The more frequent the insulin injections, the better the approximation of natural or normal insulin levels. Discuss with your medical provider the insulin regimen that is best for you.
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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.
What Are Alternative Medications For People With Diabetes That Arent Insulin
Non-insulin medications that may be prescribed to people with diabetes include:
Metformin a pill that stops sugar production in the liver
Glitazones pills that remove sugar from the bloodstream
Sulfonylureas and glinides pills that increase the release of insulin from your pancreas
Starch blockers pills that slow starch absorption
Incretin therapies and amvlin analogs pills and injections that reduce sugar production in the liver and slow food absorption. Types of the former include DPP4 inhibitors and GLP1 analogs .
SGLT2 inhibitors pills that are taken before meals that prevent the reabsorption of glucose
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Why Am I Using Ozempic
Ozempic is medication used alongside diet and exercise to improve blood sugar control in adults with type 2 diabetes. Ozempic is not used to treat type 1 diabetes or diabetic ketoacidosis. You doctor may prescribe Ozempic to be used in addition to other diabetes medications, such as metformin or insulin.
Ozempic is also approved to reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes and known heart disease.
What Causes Someone To Be Prescribed Insulin
If your body doesnt make insulin or doesnt make enough, you are eventually diagnosed with type 1 diabetes. It used to be called juvenile diabetes, but new estimates show that as many as half of people with type 1 diabetes are not diagnosed until adulthood. On the other hand, if your body doesnt use insulin properly, you have type 2 diabetes.
While people with type 1 diabetes need to take insulin to survive, many people with type 2 are able to stave off insulin use or even avoid it altogether by exercising, losing weight, adapting healthier eating habits, or using other prescription medications.
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.
Why Is Insulin So Expensive
Though reforms are underway in many parts of the US, insulin costs are still prohibitively high for many people with diabetes. Reasons include the complexity of the pharmaceutical supply chain and lack of generic substitutes. The American Diabetes Association has advocated for policy changes that would stop the trend of rising insulin costs and improve affordable access to insulin read their policy statement on the issue here.
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When Do I Take Rapid
You should inject rapid-acting insulin no more than 15 minutes before you eat. Your doctor will tell you how much insulin to inject. Remember, you should not wait more than 15 minutes to eat after you take this insulin shot.
Rapid-acting insulin can be more convenient to take than regular insulin. With regular insulin, you inject the insulin and then wait 30 to 60 minutes before eating. Many people find it hard to time their meals around regular insulin injections. Sometimes they end up eating too soon or too late. Then they dont achieve the best blood sugar control. Since rapid-acting insulin is taken so close to mealtime, it may help you control your blood sugar more effectively.
What If I Forget To Take It
Empagliflozin, or empagliflozin with linagliptin
If you miss a dose of empagliflozin or Glyxambi and it’s 12 hours or more until your next dose, take it as soon as you remember. Then take your next dose at the usual time.
If it is less than 12 hours until your next dose, skip the missed dose. Then take your next dose at the usual time.
Empagliflozin with metformin
If you miss a dose of Synjardy, take it as soon as you remember, unless it’s only a few hours until your next dose. In which case miss out the forgotten dose and take your next dose at the usual time.
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What Does Insulin Do
Insulin moves glucose from your blood into cells all over your body. Glucose comes from both food and your bodys own natural release of stored glucose. Think of insulin as the key that opens the doors of the cells in your body. Once insulin opens your cell doors, glucose can leave your bloodstream and move into your cells where you use it for energy. Without enough insulin, glucose cant get into your cells and instead builds up in your blood .
Many conditions can affect your bodys ability to produce and release insulin. They include:
- Gestational diabetes, which is diabetes that begins during pregnancy.
- Prediabetes, when your body is resistant to insulin , but blood sugar levels arent high enough for a Type 2 diabetes diagnosis.
- Type 1 diabetes, when your pancreas doesnt make insulin or doesnt make enough to control blood sugar.
- Type 2 diabetes, when your pancreas doesnt produce enough insulin, or your body cant use the insulin as it should.
- Metabolic syndrome , a group of risk factors that increase the risk of diabetes and heart disease. Insulin resistance means that the cells in your body cant use glucose from your blood as energy.
Making Unhealthy Food Choices
People with diabetes should limit sugary foods, such as juice, soda, or candy, to only when they are treating low blood sugar,” Port says. Foods high in sugar or refined carbohydrates, and sugary drinks, will quickly raise blood sugar levels, and won’t match up with a bolus insulin dose thats been measured for you based on eating meals of a similar size and carbohydrate content throughout the day.
Make it a habit to choose less processed sources of carbohydrates, such as fresh fruit, vegetables, beans, and whole grains, and balance out your meals with lean protein and healthy fats to help keep your blood sugar stable. One way to think about healthier foods and cut back on carbs, Port says, is to choose those that come from the earth or the ground, and havent been processed much. I like to use the example of eating an apple versus eating applesauce, or even drinking apple juice . The closer you can get to the simple apple, which isnt processed at all, the better.
Keeping a food journal can help you and your doctor look for patterns, and understand how your food choices are affecting your blood sugar.
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