Should I Start Insulin
If your healthcare provider decides that it is time for you to start insulin, then it probably is. In order to avoid long term complications when your beta cells have just given out, and are not making enough insulin anymore, you should start insulin if advised to do so. It would be better to take an insulin injection to get your A1C down below 7 percent, than it would be to end up with a non-healing ulcer, on the dialysis unit, or experience going blind.
For most people with diabetes, the goal is to keep the A1C below 7 percent, and to live healthy with diabetes. This can be achieved by using an individualized and patient-centered approach. Some important factors that should be taken into consideration when picking a diabetes medication are:
- the costs
Too Much Insulin Or Not Enough
High morning blood sugar levels before breakfast can be a puzzle. If you haven’t eaten, why did your blood sugar level go up? There are two common reasons for high before-breakfast blood sugar levels. One relates to hormones that are released in the early part of sleep . The other is from taking too little insulin in the evening. To see which one is the cause, set your alarm to self-monitor around 2 or 3 a.m. for several nights and discuss the results with your health care provider.
Type 1 Diabetes Disclaimer
This article is not for people with Type 1 diabetes because it is imperative that people with Type 1 diabetes require insulin every day without question. A person with Type 1 diabetes produces very little, or no insulin. Without insulin, you cannot convert food into usable energy. Simply put, without insulin, a person with Type 1 diabetes cannot survive. 2
When Robert contacted TheDiabetesCouncil, he was concerned that one day he would have to take insulin shots for his Type 2 diabetes. He had heard a few of his friends with diabetes at church talking about how they had to take insulin injections. Robert was afraid of needles, and the thought of giving himself a shot scared him.
Is Robert going to need to start taking insulin, or is there any way he can avoid it at this point? If he avoids it, what effects would this have on his health? Will he develop long term complications of diabetes if he doesnt start giving himself shots of insulin?
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At TheDiabetesCouncil, we decided to take a look at this particular question in depth, for Robert and for others with diabetes who might benefit from reading this information.
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What Happens In Type 1 Diabetes
The cause of diabetes is not known. Some experts believe diabetes is inherited , but the genetics are not clearly understood. Diabetes does not always run in families. The body mistakes the cells that produce insulin for foreign cells. The body then destroys these cells. This is called an auto-immune process. Although something in the environment may trigger the disease, there are no known ways to prevent type 1 diabetes in children.
Take Insulin As Prescribed
People who have type 1 diabetes must take insulin as part of their treatment. Because their bodies can’t make insulin anymore, they need to get the right amount to keep their blood sugar levels in a healthy range.
The only way to get insulin into the body now is by injection with a needle or with an insulin pump. If someone tried to take insulin as a pill, the acids and digestive juices in the stomach and intestines would break down the medicine, and it wouldn’t work.
Different kinds of insulin are used for different purposes. The types of insulin you use and the number of shots you take each day will depend on what’s best for you and your daily schedule.
As you grow and change, the amount of insulin you will need to take can change. Getting insulin injections today is nearly painless, thanks to smaller needles. Insulin pumps cut down on the number of injections needed.
Your diabetes health care team will teach you how and when to give yourself insulin shots.
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Insulin Sensitivity And Your Dose
You may hear your healthcare professional talk about insulin sensitivity. This is how well your body is using insulin to get your blood sugar levels down. People with high sensitivity need less insulin than those with low sensitivity.
Your healthcare professional can test you for insulin sensitivity, and this will help them decide what dose of insulin you will need, and if insulin of you need it at all.
Factors That Speed Insulin Absorption
Variation in insulin absorption can cause changes in blood glucose levels. Insulin absorption is increased by:
- injecting into an exercised area such as the thighs or arms
- high temperatures due to a hot shower, bath, hot water bottle, spa or sauna
- massaging the area around the injection site
- injecting into muscle this causes the insulin to be absorbed more quickly and could cause blood glucose levels to drop too low.
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Making The Switch To Insulin
Making the transition is much easier than it used to be because most patients are started on a long-acting insulin that does not need to be matched with food intake.
Insulin pens that are preloaded are replacing insulin that needs to be drawn up into a syringe. Patients may still be worried about giving themselves injections, but because the needle is so tiny the adjustment is often quick.
Toujeo and Lantus are long-acting forms of insulin that are available in a prefilled injectable pen.
And a new class of medication called sodium-glucose cotransporter 2 inhibitors is also available now, according to Mazhari. “It works via a different pathway that’s not pancreas-dependent, offering another medical therapy option for patients with type 2 diabetes.”
The key to an easy transition to insulin is education.
“Patients need to know how to take their insulin properly since there are many formulations on the market, including short- and long-acting insulin and premixed,” Mazhari said. “Most can be started on a long-acting insulin once a day, though for some patients short-acting or mealtime insulin may be necessary as well. Insulin doses need to be further adjusted depending on blood sugar readings.”
There Are A Number Of Treatments Available To Help You Manage And Treat Your Diabetes Everyone Is Different So Treatment Will Vary Depending On Your Own Individual Needs
If you have another type of diabetes, your treatment options may be different. Speak to your healthcare professional, or call our helpline if youre not sure.
Your GP or a healthcare professional can help you find the right diabetes treatment plan to suit you and your lifestyle.
People with diabetes are entitled to free prescriptions.
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Type 1 Diabetes And Transplantation
Another form of treating type 1 diabetes is to have an injection of insulin producing cells. This procedure, known as islet cell transplantation, allows the transplanted insulin producing islet cells to produce insulin inside your body.
Islet cell transplantation can help to reduce the amount of insulin you need to take and can make managing your diabetes easier but it is an expensive procedure and has drawbacks as well. For these reasons, islet cell transplants are only given to a small number of people each year.
Preference is given to people that experience severe hypoglycemia on a regular basis.
How Should I Store My Insulin
Like food, insulin doesnt have a forever shelf life. Its recommended that you store any insulin youre not using in the fridge.
However, injecting cold insulin may make the injection feel more painful. Because of this, a best practice is to keep the bottle of insulin youre currently using in a safe place, away from direct heat and sunlight. Insulin kept at room temperature can last about a month.
Do not store insulin in the freezer, and always check the expiration date before using it.
Side effects from injecting or receiving insulin are rare, but can occur in certain cases. The symptoms of mild allergic reactions are swelling, itching, or redness around the injection area. More severe insulin allergies may include nausea and vomiting.
In either case, talk with your doctor if you notice any of these signs.
Hypoglycemia, or blood glucose levels that are too low, can sometimes occur when you take insulin.
Its important to balance the insulin that you give yourself with food or calories. If you exercise longer or harder than usual or dont eat the right amount of calories or carbs, your glucose level can drop too low and trigger low blood sugar. Symptoms of low blood sugar include:
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Prepare The Insulin And Syringe
- Remove the plastic cap from the insulin bottle.
- Roll the bottle of insulin between your hands two to three times to mix the insulin. Do not shake the bottle, as air bubbles can form and affect the amount of insulin withdrawn.
- Wipe off the rubber part on the top of the insulin bottle with an alcohol pad or cotton ball dampened with alcohol.
- Set the insulin bottle nearby on a flat surface.
- Remove the cap from the needle.
If you’ve been prescribed two types of insulin to be taken at once , skip to the instructions in the next section.
- Draw the required number of units of air into the syringe by pulling the plunger back. You need to draw the same amount of air into the syringe as insulin you need to inject. Always measure from the top of the plunger.
- Insert the needle into the rubber stopper of the insulin bottle. Push the plunger down to inject air into the bottle . Leave the needle in the bottle.
- Turn the bottle and syringe upside-down. Be sure the insulin covers the needle.
- Pull back on the plunger to the required number of units .
- Check the syringe for air bubbles. Air bubbles in the syringe will not harm you if they are injected, but they can reduce the amount of insulin in the syringe. To remove air bubbles, tap the syringe so the air bubbles rise to the top and push up on the plunger to remove the air bubbles. Recheck the dose and add more insulin to the syringe if necessary.
- Remove the needle from the insulin bottle. Carefully replace the cap on the needle.
Managing Diabetes With Insulin
Injections of insulin can help manage both types of diabetes. The injected insulin acts as a replacement for, or a supplement to, your bodys natural insulin.
People living with type 1 diabetes cant make insulin, so they must inject insulin to control their blood glucose levels.
Many people living with type 2 diabetes can manage their blood glucose levels with lifestyle changes and oral medication. However, if these treatments dont help control glucose levels, people living with type 2 diabetes may also need supplemental insulin.
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Diagnosing Type 1 Diabetes
Doctors use different tests to determine whether someone has diabetes. They include:
Random blood sugar test: A blood sample is taken at a random time and measures the amount of glucose, or sugar, present in the blood at that moment. If the sugar level is 200 milligrams or more per decimeter or 11.1 , it may indicate diabetes.
Oral glucose test: This test involves drinking a sugary beverage after fasting and then testing the blood several times for up to two hours to determine how the body is responding to the sugar intake.
Glycated hemoglobin test: This test measures the percentage of blood sugar attached to red blood cells, or hemoglobin over the last six to 12 weeks. Since a red blood cell can live about 12 weeks, this test shows the average glucose over that time. An A1C of 6.5 percent or higher indicates diabetes. This test is often performed twice to make sure its accurate.
Fasting blood sugar test: A blood sample is taken after an overnight fast. It measures the level of sugar in the blood. A glucose level of less than 100 milligrams or more per decimeter is normal. Levels 101 to 125 mg/dL indicates prediabetes, and 126 mg/dL and over in two separate tests indicates diabetes.
When To Contact A Medical Professional
- Chest pain or pressure, shortness of breath, or other signs of angina
- Loss of consciousness
Also call your provider if you have:
- Blood sugar levels that are higher than the goals you and your provider have set
- Numbness, tingling, or pain in your feet or legs
- Problems with your eyesight
- Sores or infections on your feet
- Frequent feelings of depression or anxiety
- Symptoms that your blood sugar is getting too low
- Symptoms that your blood sugar is too high
- Blood sugar readings that are below 70 mg/dL
You can treat early signs of hypoglycemia at home by drinking orange juice, eating sugar or candy, or by taking glucose tablets. If signs of hypoglycemia continue or your blood glucose level stays below 60 mg/dL , go to the emergency room.
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Exercise Physical Activity And Weight Loss
Its important for people with Type 2 diabetes to be physically active. They should aim to get in at least 30 minutes of physical activity five days per week. If weight loss is desired, a modest goal for weight loss of five to seven percent of body weight will help decrease insulin resistance, and protect remaining beta cells in the pancreas.
Research in the United Kingdom has shown that just a small amount of weight loss around the pancreas will greatly reduce insulin resistance. Overall weight loss can help reduce visceral fat.
Jet Injection Or Jet Injector
No needle is necessary with insulin jet injectors, which should make them a great choice for “needle-phobics.” Instead, these devices use high pressure to send a fine spray of insulin through the skin. Great in theory, jet injectors never quite took off among people with diabetessome say they are more painful than needles.
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How To Measure A Mixed Dose Of Insulin
Your doctor may prescribe two types of insulin to be injected at once for diabetes. This mixed dose may provide better blood sugar control for some people.
Please follow these steps when injecting a mixed dose of insulin:
Important:This must be an exact measurement. If you withdraw too much cloudy insulin, the total dosage in the syringe must be discarded. Be careful not to push any of the clear insulin from the syringe into the cloudy insulin. If there are large air bubbles after mixing the insulin in the syringe, discard this dosage and start the procedure again. Do not push the insulin back into the bottle.
- Carefully replace the cap on the needle.
- You are now ready to inject the insulin. Follow the steps listed below.
How To Choose The Right Method For Injecting Insulin
Both syringes and insulin pens use a small needle to inject insulin into your body. There are pros and cons to each, and which one you ultimately end up with will depend on your lifestyle and your doctors advice.
Things to know about insulin syringes:
- They come in a few different sizes.
- Your doctor will tell you how much insulin you need per dose.
- You will usually draw the insulin into the syringe when you need it.
- Theyre not as discreet as an insulin pen.
Things to know about insulin pens:
- Some pens use cartridges that are manually inserted into the pen.
- Other pens are prefilled and thrown away after all the insulin is used.
- Needles in pens are often smaller than those in syringes.
- Not all types of insulin can be used with a pen.
- Pens can be more expensive than syringes and are sometimes not covered by insurance.
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Select And Clean The Injection Site
Choose an injection site for your insulin shot.
Do not inject near joints, the groin area, navel, the middle of the abdomen, or near scars.
Clean the injection site in a circular motion with an alcohol wipe or a cotton ball dampened with rubbing alcohol. Leave the alcohol wipe or cotton ball nearby.
Maintaining Ideal Glucose Levels
Outside of recognizing the symptoms of low blood sugar, the best way to keep glucose levels optimal is through regular blood testing. You and your doctor can determine the best schedule for testing to meet your needs. To help encourage a habit of testing, making it as painless and simple as possible goes a long way. Genteels Lancing Device is ideal for this purpose as it offers pain-free but accurate testing that can be done on different areas of the body so fingers dont become over stabbed and sore.
There are diabetes medications that can be taken to maintain glucose levels. People with type 1 diabetes cannot produce insulin and therefore regularly take insulin injections or wear insulin pumps. For those with type 2 diabetes, there are a variety of medicines that work with the body in different ways to help it process glucose and produce or better manage insulin. Your doctor can help you determine if diabetes medicine is right for you.
Outside of medicine, diet and choosing healthy foods can also help in stabilizing blood sugar. Adopting a diet for diabetics that is low in sugar and features vegetables, fruits, and whole grains can keep glucose levels in check. Eating at regular times and controlling food portions is also important. Regular exercise can also help your body better process sugar, just be sure to check your blood before, during, and after physical activity as exercise draws on your sugar reserves to fuel muscles.
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