When Does A Diabetic Need To Take Insulin

How Else Can I Manage Type 1 Diabetes

Along with insulin and any other medicines you use, you can manage your diabetes by taking care of yourself each day. Following your diabetes meal plan, being physically active, and checking your blood glucose often are some of the ways you can take care of yourself. Work with your health care team to come up with a diabetes care plan that works for you. If you are planning a pregnancy with diabetes, try to get your blood glucose levels in your target range before you get pregnant.

What Is Type 1 Diabetes

Diabetes occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes mainly from the food you eat. Insulin, a hormone made by the pancreas, helps the glucose in your blood get into your cells to be used for energy. Another hormone, glucagon, works with insulin to control blood glucose levels.

In most people with type 1 diabetes, the bodys immune system, which normally fights infection, attacks and destroys the cells in the pancreas that make insulin. As a result, your pancreas stops making insulin. Without insulin, glucose cant get into your cells and your blood glucose rises above normal. People with type 1 diabetes need to take insulin every day to stay alive.

When Do People With Type 2 Diabetes Start Insulin

After 10 to 20 years, many people with type 2 diabetes will begin insulin therapy, although every persons journey with type 2 diabetes is different. This happens when lifestyle changes and medications arent keeping your glucose levels in your target range. It is important that you start treatment as early as possible to avoid persistent hyperglycemia , which can lead to long-term health complications affecting your heart, kidneys, eyes, and other organs.

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Dont Inject The Insulin Too Deep

Insulin is supposed to be injected into the fat layer under the skin using a short needle. This is referred to as a subcutaneous injection.

If you inject the insulin too deep and it enters your muscle, your body may absorb it too quickly. The insulin might not last very long, and the injection could be very painful.

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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What Are The Different Ways To Take Insulin

The way you take insulin may depend on your lifestyle, insurance plan, and preferences. Talk with your doctor about the options and which one is best for you. Most people with diabetes take insulin using a needle and syringe, insulin pen, or insulin pump. Inhalers and insulin jet injectors are less common ways to take insulin. Artificial pancreas systems are now approved by the U.S. Food and Drug Administration . Talk with your doctor to see if an artificial pancreas is an option for you.

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 or a continuous 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 your doctor. Your doctor needs this information to determine how much insulin is right for you.

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Ways To Lower Your Odds For Needing Insulin

Before people start on insulin therapy, you may be asked to engage in changing your lifestyle. Intensive lifestyle interventions can prevent those with pre-diabetes from developing full blown type 2 diabetes by 58%, according to a clinical trial of over 5,000 people published in Diabetes Care. Lifestyle interventions include eating healthier, exercising, losing weight, getting emotional support, and sleeping well. But its a very hard thing for many to commit to exercise and diet in a very strict way, Dr. Levy says.

Whether youre taking oral medications or insulin, lifestyle modifications can help manage your blood sugar levels, Dr. Levy says. Heres what works:

Medication changes arent always possible for someone with mental health issues, such as schizophrenia. We have many, many options to treat blood sugars. But it could be that they finally found the right drug for their psychiatric disorder. So, we will work around it, Dr. Levy says.

Even after making serious lifestyle changes, your body can still need insulin to function properly. That doesnt mean youve failed or that youre not trying hard enough.

Diabetes is a progressive disease. We know that insulin-producing beta cells fail over time. Even for people who eat perfectly, take their medicine, and whove lost weight. They may still need insulin injections. It doesnt mean theyve done anything wrong. Its just the nature of diabetes, Hinnen says.

What Should I Know About Storage And Disposal Of This Medication

Store unopened vials of human insulin, unopened disposable dosing devices and unopened human insulin pens in the refrigerator. Do not freeze human insulin and do not use human insulin that has been frozen. Opened vials of human insulin should be stored in the refrigerator but may also be stored at room temperature, in a cool place that is away from heat and direct sunlight. Store opened human insulin pens and opened dosing devices at room temperature. Check the manufacturer’s information to find out how long you may keep your pen or dosing device after the first use.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.

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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:

What Other Information Should I Know

Keep all appointments with your doctor and the laboratory. Your blood sugar and glycosylated hemoglobin should be checked regularly to determine your response to human insulin. Your doctor will also tell you how to check your response to human insulin by measuring your blood or urine sugar levels at home. Follow these directions carefully.

You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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Common Questions About Type 2 Diabetes:

• Can type 2 diabetes go away?
• Will I need to take insulin?
• Do I have to take it forever?

• Can type 2 diabetes be prevented?

How do you treat type 2 diabetes?

When you have type 2 diabetes, you first need to eat a healthy diet, stay physically active and lose any extra weight. If these lifestyle changes cannot control your blood sugar, you also may need to take pills and other injected medication, including insulin.

Eating a healthy diet, being physically active, and losing any extra weight is the first line of therapy. Diet and exercise is the foundation of all diabetes management because it makes your bodys cells respond better to insulin and lowers blood sugar levels.

If you cannot normalize or control the blood sugars with diet, weight loss and exercise, the next treatment phase is taking medicine either orally or by injection.

Diabetes pills work in different ways some lower insulin resistance, others slow the digestion of food or increase insulin levels in the blood stream. The non-insulin injected medications for type 2 diabetes have a complicated action but basically lower blood glucose after eating. Insulin therapy simply increases insulin in the circulation.

Many people with type 2 diabetes have elevated blood fats and blood pressure, so you may be given medications for these problems as well.

Can type 2 diabetes go away? And if my blood sugar becomes normal, do I still have diabetes?

Will I need to take insulin if I have type 2 diabetes?

When To Contact A Medical Professional

• Chest pain or pressure, shortness of breath, or other signs of angina
• Loss of consciousness

• 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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The Goal Of Insulin Is To Mimic The Pancreas

If you do need insulin, your healthcare provider may prescribe one of five primary types of insulin available depending on your body’s metabolismrapid-acting, regular or short-acting, intermediate-acting, long-acting, or ultra-long-acting. These different insulin types will vary in the following aspects:

• How quickly or slowly they reach the bloodstreamknown as the onset
• The amount of time they work at maximum strengthcalled the peak time
• How long the insulin continues to be effectiveknown as the duration

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.

Causes Of Type 1 Diabetes

Type 1 diabetes is an autoimmune condition, where the immune system mistakes the cells in your pancreas as harmful and attacks them.

Without insulin, your body will break down its own fat and muscle, resulting in weight loss. This can lead to a serious short-term condition called diabetic ketoacidosis. This is when the bloodstream becomes acidic, you develop dangerous levels of ketones in your blood stream and become severely dehydrated.

This results in the body being unable to produce insulin, which is required to move glucose out of the blood and into your cells to be used for energy. This is called Type 1 diabetes.

Read more about the causes of type 1 diabetes

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When Should Insulin Be Started

Conor Best, MD, and Kim A. Carmichael, MDSeries Editor

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.

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Q. Are there certain circumstances where insulin should be considered sooner?

Q. Are there patients who should not receive insulin?

References:

Insulin Is Vital To Your Health

Insulin is a hormone produced by your pancreas. It helps your body use and store sugar from food.

If you have type 2 diabetes, your body doesnt respond effectively to insulin. The pancreas isnt able to compensate properly, so theres a relatively decreased insulin production. As a result, your blood sugar levels get too high. Over time, high blood sugar can cause damage to your nerves, blood vessels, eyes, and other tissues.

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What Are The Symptoms Of Type 1 Diabetes

Symptoms of type 1 diabetes are serious and usually happen quickly, over a few days to weeks. Symptoms can include

• increased thirst and urination

• trouble breathing
• trouble paying attention or feeling confused

DKA is serious and dangerous. If you or your child have symptoms of DKA, contact your health care professional right away, or go to the nearest hospital emergency room.

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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What Is Different About Insulin Lispro

Insulin lispro is a new type of insulin. It starts working sooner than other insulin types. It also reaches peak activity faster and goes away sooner. Insulin lispro helps keep your blood sugar level from going too high after you eat. To keep your blood sugar level steady, your doctor will probably prescribe either a longer-acting insulin or another drug for you to take each day in addition to the insulin lispro.

If you need to mix insulin lispro with a longer-acting insulin, it’s best that you mix insulin lispro only with Humulin U or Humulin N, which are brand names for certain longer-acting insulins. Insulin lispro should always be drawn into the syringe first. This will keep the longer-acting insulin from getting into the insulin lispro bottle.

Dont Switch Your Insulin Dose Or Stop Taking It Without Seeing Your Doctor First

Switching your insulin medication or changing the dose without asking a doctor can put you at risk for serious side effects and complications.

If you have type 2 diabetes, you should be seeing your doctor or endocrinologist for a checkup roughly every 3 to 4 months. At your appointment, your doctor can assess your individual insulin needs and give you proper training on new doses or dosing methods.

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