Does Type 1 Diabetes Need Insulin

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.

Can I Mix Rapid

You can mix a rapid-acting insulin with an intermediate-acting insulin, according to your doctors instructions. Rapid-acting insulin should always be drawn into the syringe first. This will keep the intermediate-acting insulin from getting into the rapid-acting insulin bottle. After mixing rapid-acting insulin in the same syringe with an intermediate-acting insulin, you must inject the mixture under your skin within 15 minutes. Remember to eat within 15 minutes after the injection.

Example #: Carbohydrate Coverage At A Meal

First, you have to calculate the carbohydrate coverage insulin dose using this formula:

CHO insulin dose = Total grams of CHO in the meal ÷ grams of CHO disposed by 1 unit of insulin .

For Example #1, assume:

• You are going to eat 60 grams of carbohydrate for lunch
• Your Insulin: CHO ratio is 1:10

To get the CHO insulin dose, plug the numbers into the formula:

CHO insulin dose =

• The carbohydrate coverage dose is 6 units of rapid acting insulin.
• The high blood sugar correction dose is 2 units of rapid acting insulin.

Now, add the two doses together to calculate your total meal dose.

Carbohydrate coverage dose + high sugar correction dose = 8 units total meal dose!

The total lunch insulin dose is 8 units of rapid acting insulin.

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How Are Type 1 And Type 2 Diabetes Diagnosed

The primary test used to diagnose both type 1 and type 2 diabetes is known as the A1C, or glycated hemoglobin, test.

This blood test determines your average blood sugar level for the past 2 to 3 months. Your doctor may draw your blood or give you a small finger prick.

The higher your blood sugar levels have been over the past few months, the higher your A1C level will be. Test results are expressed as a percentage. An A1C level of 6.5 percent or higher indicates diabetes.

The A1C test isnt accurate for people with sickle cell anemia or the sickle cell trait. If you have this condition or trait, then your doctor will have to use a different test.

Type 1 Diabetes Causes

Insulin is a hormone that helps move sugar, or glucose, into your body’s tissues. Your cells use it as fuel.

Damage to beta cells from type 1 diabetes throws the process off. Glucose doesnât move into your cells because insulin isnât there to do the job. Instead, it builds up in your blood, and your cells starve. This causes highblood sugar, which can lead to:

• Dehydration. When thereâs extra sugar in your blood, you pee more. Thatâs your bodyâs way of getting rid of it. A large amount of water goes out with that urine, causing your body to dry out.
• Weight loss. The glucose that goes out when you pee takes calories with it. Thatâs why many people with high blood sugar lose weight. Dehydration also plays a part.
• Diabetic ketoacidosis . If your body can’t get enough glucose for fuel, it breaks down fat cells instead. This creates chemicals called ketones. Your liver releases the sugar it stores to help out. But your body canât use it without insulin, so it builds up in your blood, along with the acidic ketones. This mix of extra glucose, dehydration, and acid buildup is known as ketoacidosis and can be life-threatening if not treated right away.
• Damage to your body. Over time, high glucose levels in your blood can harm the nerves and small blood vessels in your eyes, kidneys, and heart. They can also make you more likely to get hardened arteries, or atherosclerosis, which can lead to heart attacks and strokes.

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The Discovery Of Insulin

Way back when, in 1921, a surgeon named Frederick Banting figured out how to extract secretions from islet cells in the pancreas as a possible treatment for diabetes, overseen by John MacLeod, the head of physiology at the University of Toronto. Bantings assistant, Charles Best, helped to refine the process.

The first injection of insulin was given to a 14-year-old named Leonard Thompson who, at the time, weighed 65 pounds and was dying of type 1 diabetes. He had an allergic reaction to the substance, but he recovered and gained back his strength. In April of that same year, this miraculous substance was named insulin, from the Latin word insula, which means island.

In 1923, Eli Lilly began to mass-produce insulin from the pancreases of cows and pigs, and they named their insulin Iletin. This discovery of insulin is one of medicines most significant advances. A lot about insulin has changed since those initial days of discovery, and its all for the better. Today, there are many different types of insulin that work in different ways to try and mimic what the pancreas does in a person without type 1 diabetes.

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Insulin Helps You Live Better

The goal of diabetes management is for you to live a good life, free from complications and illness. A fine-tuned insulin regimen is critical to your success.

When your type 1 diabetes is well-controlled, you will feel your best. This allows you to enjoy life to its fullest and maintain your health long-term.

Here at DETs, we focus on wellness, not an illness. Were ready to work with you to create a diabetes care plan that helps you live better.

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What Is Insulin And Why Do Some Diabetics Need To Take It

Dr. Saudek answers the question: ‘What Is Insulin & Why Is It Needed?’

— Question: What is insulin and why do some diabetics need to take it?

Answer: Insulin is a hormone. It’s made by certain cells in the pancreas, which are called the beta cells of the pancreas, and the beta cells from the pancreas are part of these little islets called the Islets of Langerhans. That’s where insulin normally comes from, and in type 2 diabetes there is always some insulin coming out from those beta cells in type 1 diabetes, you tend to lose the beta cells and make no insulin.

Since 1921 or so, though, insulin has been available as a pharmacologic approach, so you can take insulin by injection, and you can replace what’s not being made in the pancreas.

Type 1 Diabetes Mellitus And The Use Of Flexible Insulin Regimens

IRL B. HIRSCH, M.D., University of Washington School of Medicine, Seattle, Washington

Am Fam Physician. 1999 Nov 15 60:2343-2352.

See related patient information handout on flexible insulin regimens, provided by an AAFP staff patient education writer.

This article exemplifies the AAFP 1999 Annual Clinical Focus on the prevention and management of the complications of diabetes.

• References

Over the past 30 years, dramatic changes have occurred in the management of type 1 diabetes mellitus .13 Insulin replacement strategies now stress the importance of administering smaller doses of insulin throughout the day. This approach allows insulin doses to be changed as needed to correct hyperglycemia, supplement for additional anticipated carbohydrate intake or subtract for exercise.

Although significant effort is required, it has become theoretically possible to maintain near-normal glycemia in most patients with type 1 diabetes. The 1993 report from the Diabetes Control and Complications Trial demonstrated that meticulous glycemic control is possible and reduces the occurrence of microvascular complications in patients who have type 1 diabetes.4

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What Are The Risk Factors For Type 1 And Type 2 Diabetes

Risk factors for type 1 diabetes include:

• Family history: People with a parent or sibling with type 1 diabetes have a higher risk of developing it themselves.
• Age: Type 1 diabetes can appear at any age, but its most common among children and adolescents.
• Geography: The prevalence of type 1 diabetes increases the farther away you are from the equator.
• Genetics: The presence of certain genes points to an increased risk of developing type 1 diabetes.

Youre at risk of developing type 2 diabetes if you:

• have prediabetes, or slightly elevated blood sugar levels
• are carrying excess weight or have obesity
• are Black, Hispanic, American Indian, or Alaska Native
• have an immediate family member with type 2 diabetes

Getting Started With Insulin If You Have Type 2 Diabetes

New to insulin? Learn about insulin dosing and timing and how often to test your blood sugar levels if you have type 2 diabetes.

If you have type 2 diabetes, it is likely that your treatment regimen will change over time as your needs change, and at some point, your healthcare professional may suggest that you start taking insulin. While this might feel scary, there are millions of others living with type 2 diabetes and taking insulin, so its definitely manageable.

Talk to your doctor and diabetes treatment team.Patient Guide to InsulinTypes of InsulinHow Much Insulin Should You Take?Where Should You Inject the Insulin?

• Abdomen

Newer, Easier Ways to Inject Insulininsulin deliveryA Final Note about Insulin

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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

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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Whats It Like For Teens With Type 2 Diabetes

Sometimes people who have diabetes feel different from their friends because they need to think about how they eat and how to control their blood sugar levels every day.

Some teens with diabetes want to deny that they even have it. They might hope that if they ignore diabetes, it will just go away. They may feel angry, depressed, or helpless, or think that their parents are constantly worrying about their diabetes management.

If youve been diagnosed with type 2 diabetes, its normal to feel like your world has been turned upside down. Your diabetes care team is there to provide answers and support. Dont hesitate to ask your doctors, dietitian, and other treatment professionals for advice and tips. It also can help to find support groups where you can talk about your feelings and find out how other teens cope.

Diabetes brings challenges, but teens who have it play sports, travel, date, go to school, and work just like their friends.

Why Insulin Can Become Necessary For A Person With Type 2 Diabetes

Starting insulin treatment should not be seen as a setback.

People with type 2 diabetes may require insulin when their meal plan, weight loss, exercise and antidiabetic drugs do not achieve targeted blood glucose levels.

Diabetes is a progressive disease and the body may require insulin injections to compensate for declining insulin production by the pancreas. That is why starting insulin treatment should never be seen as a failure.

Starting insulin treatment should never be seen as a failure.

Treatment with insulin may be added to an antidiabetic medication or completely replace it. Regardless of the treatment, lifestyle habits are essential to managing diabetes.

Many people are reluctant to inject insulin for various reasons:

• Fear of pain or needles
• Guilt
• Impression that this is the last resort
• Fear of hypoglycemic attacks
• Fear of weight gain
• Memories of loved one who had to take insulin

If this is the case, do not hesitate to discuss your concerns with a health care professional. Some of your fears may be due to false beliefs. Learning more about todays insulin treatment will probably allay your fears. For many people, insulin is an effective way to achieve good blood-sugar control, which can prevent or delay certain diabetes complications over the long term.

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How To Know When You’ll Need Insulin

Injecting insulin above and to the side of the belly button can result in more consistent results.

There’s no simple way to tell when a patient with type 2 would do best on insulin, says Richard Hellman, MD, former president of the American Association of Clinical Endocrinologists. But there are guidelines.

“In general if a patient has a hemoglobin A1C that is higher than the agreed upon goal and they are not on insulin, we recommend insulin therapy,” Dr. Hellman says. The American Diabetes Association recommends an A1C of 7% or below, and the American College of Endocrinology and the American Association of Clinical Endocrinologists recommend an A1C of 6.5% or below.

If you can’t lower your A1C with diet, exercise, or other medications, you may need insulin to do the job.

Exceptions to the insulin ruleThere are exceptions, of course. Someone who otherwise seems to be a good candidate for insulin may not be able to manage such a regimen if he or she has limited vision and dexterity and no family support. Good News About Today’s Improved Insulins

• Why Insulin Use Isn’t Always Permanent

If you do need insulin in the short- or long-term, your doctor may prescribe one of four different types. These vary by 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 .

According to the American Diabetes Association , your need for insulin is based on several factors.

What Else Do I Need To Know About Taking Insulin

Staying in contact with your healthcare team is the best way to make the transition to insulin therapy. Though the first few days or weeks will be challenging, with the right support, youll find a diabetes care plan that works for you.

If you were recently diagnosed with type 2 diabetes, check out more resources here.

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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.

Symptoms Of Type 1 And Type 2

Type 1 and type 2 diabetes share common symptoms. They are:

• going to the toilet a lot, especially at night
• being really thirsty
• feeling more tired than usual
• losing weight without trying to
• genital itching or thrush
• cuts and wounds take longer to heal
• blurred vision.

But where type 1 and type 2 diabetes are different in symptom is how they appear. Type 1 can often appear quite quickly. That makes them harder to ignore. This is important because symptoms that are ignored can lead to diabetic ketoacidosis .

But type 2 diabetes can be easier to miss. This is because it develops more slowly, especially in the early stages. That makes it harder to spot the symptoms. That is why it is important to know your risk of developing type 2 diabetes. Some people have diabetes and dont know it. They can have it for up to 10 years without knowing.

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Where Do I Inject The Insulin

Insulin is injected just under the skin. Your doctor or his or her office staff will show you how and where to give an insulin injection. The usual places to inject insulin are the upper arm, the front and side parts of the thighs, and the abdomen. Dont inject insulin closer than 2 inches from your belly button.

To keep your skin from thickening, try not to inject the insulin in the same place over and over. Instead, rotate injection places.