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 thats 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.
What Is Continuous Glucose Monitoring
Advancements in technology have given us another way to monitor glucose levels. Continuous glucose monitoring uses a tiny sensor inserted under your skin. You don’t need to prick your finger. Instead, the sensor measures your glucose and can display results anytime during the day or night. Ask your healthcare provider about continuous glucose monitors to see if this is an option for you.
How Should This Medicine Be Used
Human insulin comes as a solution and a suspension . to be injected subcutaneously . Human insulin is usually injected subcutaneously several times a day, and more than one type of insulin may be needed. Your doctor will tell you which type of insulin to use, how much insulin to use, and how often to inject insulin. Follow these directions carefully. Do not use more or less insulin or use it more often than prescribed by your doctor.
Human insulin solution may also be injected intravenously by a doctor or nurse in a healthcare setting. A doctor or nurse will carefully monitor you for side effects.
Human insulin controls high blood sugar but does not cure diabetes. Continue to use human insulin even if you feel well. Do not stop using insulin without talking to your doctor. Do not switch to another brand or type of insulin or change the dose of any type of insulin you use without talking to your doctor.
Human insulin comes in vials, prefilled disposable dosing devices, and cartridges. The cartridges are designed to be placed in dosing pens. Be sure you know what type of container your insulin comes in and what other supplies, such as needles, syringes, or pens, you will need to inject your medication. Make sure that the name and letter on your insulin are exactly what your doctor prescribed.
If your human insulin comes in a disposable dosing device, read the instructions that come with the device carefully. Ask your doctor or pharmacist to show you how to use the device.
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What Happens If You Avoid Taking Your Insulin
If you have type 1 diabetes, taking insulin is essential and you cannot live without it. If you avoid taking it, your blood sugar levels can become too high and you risk developing diabetic ketoacidosis . If left untreated, DKA could be life-threatening. Thats why its important to make sure you take your insulin.
If you have type 2 diabetes and use insulin to treat your condition, you should continue to take it as prescribed. If you avoid taking it, your blood sugar levels could become too high and you may become ill. Please speak to your healthcare professional if you have any questions or concerns about taking your insulin.
Insulin is a treatment that helps manage blood sugars, so this also reduces the risk of serious long-term complications as well a shorter-term consequences. 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, but insulin is also an important part of your treatment.
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.
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Check Blood Sugar Levels
Checking your blood sugar levels is another part of your diabetes treatment plan. It lets you know how well the other parts of your treatment like your insulin injections and meal plan are working.
Your diabetes care team may recommend that you use a continuous glucose monitor . A CGM is a wearable device that can measure blood sugar every few minutes around the clock. Its measured by a thread-like sensor inserted under the skin and secured in place. Sensors can stay in place for about a week before they have to be replaced and are accurate enough to replace frequent finger-stick testing. The more frequent CGM blood sugar readings can help you and the care team do an even better job of troubleshooting and adjusting your insulin doses and diabetes management plan to improve blood sugar control.
A blood glucose meter or CGM tells you what your blood sugar level is at the moment. Your doctor may also send you for another type of blood sugar test that tells you how your blood sugar levels have been for the 3 months before the test.
How To Reverse Insulin Resistance
If you have insulin resistance, you want to become the oppositemore insulin sensitive .
Physical activity makes you more sensitive to insulin, one reason why its a cornerstone of diabetes management . Dont wait until youre diagnosed with diabetes to start moving more. The earlier you take action , the better off youll be.
Weight loss is important too, as is avoiding high blood sugar, reducing stress, and getting enough sleep .
These lifestyle changes really work. Talk with your health care provider about how to get started.
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How Is Diabetes Treated
Treatments for diabetes depend on your type of diabetes, how well controlled your blood glucose level is and your other existing health conditions.
- Type 1 diabetes: If you have this type, you must take insulin every day. Your pancreas no longer makes insulin.
- Type 2 diabetes: If you have this type, your treatments can include medications , insulin and lifestyle changes such as losing weight, making healthy food choices and being more physically active.
- Prediabetes: If you have prediabetes, the goal is to keep you from progressing to diabetes. Treatments are focused on treatable risk factors, such as losing weight by eating a healthy diet and exercising . Many of the strategies used to prevent diabetes are the same as those recommended to treat diabetes .
- Gestational diabetes: If you have this type and your glucose level is not too high, your initial treatment might be modifying your diet and getting regular exercise. If the target goal is still not met or your glucose level is very high, your healthcare team may start medication or insulin.
Oral medications and insulin work in one of these ways to treat your diabetes:
- Stimulates your pancreas to make and release more insulin.
- Slows down the release of glucose from your liver .
- Blocks the breakdown of carbohydrates in your stomach or intestines so that your tissues are more sensitive to insulin.
- Helps rid your body of glucose through increased urination.
Can Diabetes Be Cured Or Reversed
Although these seem like simple questions, the answers are not so simple. Depending on the type of your diabetes and its specific cause, it may or may not be possible to reverse your diabetes. Successfully reversing diabetes is more commonly called achieving remission.
Type 1 diabetes is an immune system disease with some genetic component. This type of diabetes cant be reversed with traditional treatments. You need lifelong insulin to survive. Providing insulin through an artificial pancreas is the most advanced way of keeping glucose within a tight range at all times most closely mimicking the body. The closest thing toward a cure for Type 1 is a pancreas transplant or a pancreas islet transplant. Transplant candidates must meet strict criteria to be eligible. Its not an option for everyone and it requires taking immunosuppressant medications for life and dealing with the side effects of these drugs.
Its possible to reverse prediabetes and Type 2 diabetes with a lot of effort and motivation. Youd have to reverse all your risk factors for disease. To do this means a combination of losing weight, exercising regularly and eating healthy . These efforts should also lower your cholesterol numbers and blood pressure to within their normal range. Bariatric surgery has been shown to achieve remission in some people with Type 2 diabetes. This is a significant surgery that has its own risks and complications.
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What Causes Acetone In The Urine
When the body cant use glucose because of the lack of insulin, the body uses fat for energy. This causes weight loss. When large amounts of fat are broken down too quickly, acetones are produced. Acetone builds up in the blood and “spills over” into the urine. Too many ketone acids in the blood may result in ketoacidosis.
Some Side Effects Can Be Serious If You Experience Any Of The Following Symptoms Call Your Doctor Immediately:
- rash and/or itching over the whole body
- shortness of breath
- large weight gain in a short period of time
- swelling of the arms, hands, feet, ankles, or lower legs
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
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Injecting Insulin: Addressing Fears Head On
The two main ways to take insulin are by injection and by using an insulin pump . There is one type of insulin that is available via an inhaler, but its a rapid-acting insulin that is given before meals. If you use this type of insulin, you still need to take a longer-acting insulin via injection.
One way to get over your fears and concerns about taking insulin is to tackle them head on. For starters, let your doctor, nurse practitioner and/or diabetes educator know about your concerns. Talking it out is one way to dispel fears and possible misconceptions.
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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What Pills Are Available To Treat Diabetes
A variety of pills can treat diabetes, but they cant help everyone. They only work if your pancreas still produces some insulin, which means they cant treat type 1 diabetes. Pills arent effective in people with type 2 diabetes when the pancreas has stopped making insulin.
Some people with type 2 diabetes can benefit from using both medication and insulin. Some pills to treat diabetes include:
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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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What Is Insulin The Role Of Insulin In The Body
Insulin is a hormone produced by the pancreas that allows your body to use glucose from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keep your blood sugar levels from getting too high or too low .
If you dont have diabetes, insulin can help:
- Regulate blood sugar levels. After you eat, carbohydrates are broken down into glucose a sugar that is the bodys main source of energy. Then, glucose enters the bloodstream. The pancreas responds by producing insulin, allowing glucose to enter the bodys cells to provide energy.
- Store extra glucose for energy. After you eat extra glucose is deposited in the liver in the form of glycogen. Between meals , the liver releases glycogen into the bloodstream in the form of glucose this keeps blood sugar levels within a narrow range.
If you have diabetes:
Your blood sugar levels will continue to rise after you eat because there isnt enough insulin to move the glucose into your bodys cells. People with type 1 diabetes make little or no insulin. Meanwhile, people with type 2 diabetes dont produce enough insulin or dont use insulin efficiently .
Untreated, high blood sugar levels can eventually lead to complications, such as kidney damage and never damage.
Treating High Blood Glucose
Hyperglycaemia can occur when your blood glucose levels become too high. It can happen for several reasons, such as eating too much, being unwell or not taking enough insulin.
If you develop hyperglycaemia, you may need to adjust your diet or your insulin dose to keep your glucose levels normal. Your diabetes care team can advise you about the best way to do this.
If hyperglycaemia isn’t treated, it can lead to a condition called diabetic ketoacidosis, where the body begins to break down fats for energy instead of glucose, resulting in a build-up of ketones in your blood.
Diabetic ketoacidosis is very serious and, if not addressed quickly, it can lead to unconsciousness and, eventually, death.
The signs of diabetic ketoacidosis include:
- frequently passing urine
Read more about the symptoms of diabetic ketoacidosis
Your healthcare team will educate you on how to decrease your risk of ketoacidosis by testing your own blood for ketones using blood ketone sticks if you’re unwell.
If you develop diabetic ketoacidosis, you’ll need urgent hospital treatment. You’ll be given insulin directly into a vein . You may also need other fluids given by a drip if you’re dehydrated, including salt solution and potassium.
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Taking Insulin Means Youve Failed
This is a big myth, says Jill Crandall, MD, professor of clinical medicine and director of the diabetes clinical trial unit at the Albert Einstein College of Medicine, in the Bronx, N.Y. Many people who try very hard to adhere to a diet, exercise, and lose weight will still need insulin.The fact is that type 2 diabetes is a progressive illness, meaning that over time you may need to change what you do to make sure your blood sugar is in a healthy range. Eating right and exercise will always be important, but medication needs can vary.A large percentage of people with type 2 diabetes will ultimately need insulin, and we dont see it as a failure, she says.
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How Much Insulin Should You Take
Your doctor will calculate the dosage for you the first time you take insulin, and he or she will work with you to figure out the best insulin plan. He or she will take into consideration your weight, age, diet, overall health, and treatment goals.
After you have the doctors plan, you will adjust the insulin doses, based on how your blood glucose level responds. Say, for example, that you take a certain dose before breakfast. If your blood glucose is too high afterward, you know that you should take more insulin the next time.
Figuring out the best insulin dose is a matter of trial and error. You should work closely with your diabetes treatment team to monitor how well your insulin is working and to adjust the insulin dose to achieve your blood sugar goals.
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