When To Take Insulin For Type 2 Diabetes

How To Get Off Insulin

If you want to stop insulin, there are several ways to make this happen

Reduce insulin resistance. A big reason why type 2 diabetics require insulin is because their cells are so resistant to insulin that they require way more insulin to overcompensate for this resistance to help get the sugar into the cells. This is a big reason why many believe the pancreas burns out over time from having to work so hard to produce abnormally high amounts of insulin.

There are drugs that help to reduce insulin resistance, and as a direct result they help to lower your blood sugar and the required insulin units that you need. Exercise is a great way to reduce insulin resistance. Although it is important to speak with your doctor before exercise as this can cause your blood sugar to drop too low if you are exercising while taking insulin.

Lose Weight if youre overweight. Fat around the midsection and your organs increases insulin resistance, which increases your insulin needs.

NOTE: Insulin promotes weight gain. One of many reasons for this is because it helps the cells of your body get sugar instead of those calories from sugar being lost in the urine.

Test your blood sugar more regularly. I know of some type 1 diabetics who test their sugar 8 times per day. The more you have an understanding of how food, exercise, and insulin affect your blood sugar, the easier it is to tweak and control it.

Prior to using any of this material, please consult with your physician.

Choosing The Correct Type Of Insulin

• References

Insulin regimens should be tailored to the patient’s needs and lifestyle. One of the most important considerations is the pharmacokinetics of different insulin preparations 26 . Table 2 defines commonly used terms in insulin therapy.

Pharmacokinetic Profiles of Insulin Therapies

*NPH/regular: Humulin 70/30, Novolin 70/30, Humulin 50/50 NPH/lispro or aspart: Humalog 75/25, Novolog 70/30, Humalog 50/50.

Adapted with permission from Endotext.org. Insulin pharmacology, types of regimens and adjustments. . Accessed December 6, 2010.

Pharmacokinetic Profiles of Insulin Therapies

*NPH/regular: Humulin 70/30, Novolin 70/30, Humulin 50/50 NPH/lispro or aspart: Humalog 75/25, Novolog 70/30, Humalog 50/50.

Adapted with permission from Endotext.org. Insulin pharmacology, types of regimens and adjustments. . Accessed December 6, 2010.

Onset of action, peak, and duration of exogenous insulin preparations.

Adapted from Hirsch IB. Insulin analogues. N Engl J Med. 2005 352:177.

Figure 2.

Onset of action, peak, and duration of exogenous insulin preparations.

Adapted from Hirsch IB. Insulin analogues. N Engl J Med. 2005 352:177.

Commonly Used Terms in Insulin Therapy

Commonly Used Terms in Insulin Therapy

Type 2 Diabetes: How To Start Insulin

Once-Daily Insulin May Be a Starting Point, Study Suggests

Oct. 24, 2007 — Do you have type 2 diabetes and need to start taking insulin? Scientists have new insights on how you should do so.

Taking insulin once daily at bedtime may be a first step, with fewer risks than other insulin-dosing strategies, a new study shows.

Those findings are preliminary, so patients should ask their doctors what they recommend.

But diabetes experts are certain of this: Get your hemoglobin A1c below 7% to cut your risk of heart attack, stroke, and other diabetes complications — and if that means taking insulin, so be it.

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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:

• storing unopened insulin on its side in a fridge
• keeping the fridge temperature between 2 and 8°C
• making sure that insulin does not freeze
• once opened, keeping it at room temperature for not more than one month and then disposing of it safely
• avoiding 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 Is An Insulin Reaction

If youre going to use rapid-acting insulin, you need to be aware of insulin reactions and how to treat them. Rapid-acting insulin begins to work very quickly. So while you and your doctor are working to find the right dosage of this insulin, you may have some insulin reactions.

Hypoglycemia is the name for a condition in which the level of sugar in your blood is too low. If you use insulin, your blood sugar level can get too low if you exercise more than usual or if you dont eat enough. It also can get too low if you dont eat on time or if you take too much insulin. Most people who take insulin have insulin reactions at some time. Signs of an insulin reaction and hypoglycemia include the following:

• Feeling very tired.
• Being unable to speak or think clearly.
• Losing muscle coordination.
• Suddenly feeling like youre going to pass out.
• Becoming very pale.

• Candy: 5 Lifesavers.
• Glucose tablets: 3 tablets .

If you dont feel better 15 minutes after having a fast-acting carbohydrate, or if monitoring shows that your blood sugar level is still too low, have another 15 grams of a fast-acting carbohydrate.

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Insulin As Treatment For Diabetes

Injections of insulin can help treat both types of diabetes. The injected insulin acts as a replacement for or supplement to your bodys insulin. People with type 1 diabetes cant make insulin, so they must inject insulin to control their blood glucose levels.

Many people with type 2 diabetes can manage their blood glucose levels with lifestyle changes and oral medication. However, if these treatments dont help to control glucose levels, people with the condition may also need insulin to help control their blood glucose levels.

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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Avoiding Injection Bruises And Lumps

Bruising can happen when you catch a tiny capillary under the skin where you have injected. It is quite normal for this to happen occasionally when you are injecting regularly and youre not doing anything wrong.

If you are concerned, you could make an appointment with your diabetes specialist nurse who will be able to do a review of your injection technique. In some cases, bleeding and bruising can be reduced by something as simple as using a different sized needle or changing your needle after each injection.

Some people notice hard lumps that can form if you inject in the same place too often. This might be lipohypertrophy , or could be something called cutaneous amyloidosis. These lumps can stop the insulin from working properly, so make sure you rotate where you inject and choose a different spot each time. If you notice any lumps, especially if they’re not going away, speak to your healthcare professional for more advice.

Other side effects from injecting a lot can be itching, rashes and other skin irritations. Changing where you inject helps with this too. You can also get treatments from your local pharmacy that can will help with the irritation.

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.

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Why Is This Medication Prescribed

Human insulin is used to control blood sugar in people who have type 1 diabetes or in people who have type 2 diabetes that cannot be controlled with oral medications alone. Human insulin is in a class of medications called hormones. Human insulin is used to take the place of insulin that is normally produced by the body. It works by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. All of the types of insulin that are available work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar.

Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication, making lifestyle changes , and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage , eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

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.

Types of insulin

Each type of insulin works at a different speed and lasts for a different length of time.

• Quick-acting, such as insulin lispro , begins to work very quickly and lasts for 3 to 4 hours.

• Short-acting, such as Regular insulin, starts working within 30 minutes and lasts about 5 to 8 hours.

• Intermediate-acting, such as NPH or Lente insulin, starts working in 1 to 3 hours and lasts 16 to 24 hours.

• Long-acting, such as Ultralente insulin, doesn’t start to work for 4 to 6 hours, but lasts 24 to 28 hours.

• NPH and Regular insulin mixture, two types of insulin mixed together in 1 bottle, starts working in 30 minutes and lasts 16 to 24 hours.

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Oral Medications Are Better Than Insulin

Oral diabetes medications can be great when it comes to lowering blood glucose levels. Many have been used for years and are very safe, such as metformin.Still, they dont work for everyone. “For some people, insulin is the easiest and best because it always works, but some people respond to pills, and others dont,” says Dr. Crandall.Not all oral medications have a tried-and-true safety record. For example,

Avandia was restricted by the FDA because of research suggesting that it ups the risk of heart attack.

What Are The Different Types Of Insulin

The key to transitioning to insulin is knowing your options. Some people taking insulin need to use both a basal and a prandial insulin each day, while others may only need to use basal insulin. Learn about your options here.

• Basal insulins are designed to be injected once or twice daily to provide a constant background level of insulin throughout the day. Basal insulins help keep blood sugars at a consistent level when you are not eating and through the night but cannot cover carbohydrates eaten for meals or snacks or glucose spikes after meals.

• Some people use other medications, like GLP-1 agonists, to help cover mealtimes. GLP-1/basal combination treatments for people with type 2 diabetes combine basal insulin with GLP-1 agonist medication in one daily injection. This combination can effectively lower glucose levels while reducing weight gain and risk of hypoglycemia . Learn more here.

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What Is Insulin Used For

Insulins main job is to keep your blood sugar levels from getting too high. After a meal, your pancreas releases the hormone insulin into your bloodstream. Insulin travels through your body where it helps take sugar out of your blood and move it into cells for energy.

In some cases, your body may not make or respond to its own natural insulin the way it should. Therefore, you may need to use an insulin medication to manage your blood sugar levels.

Insulin Is A Treatment Of Last Resort

Although some people exhaust all possible diabetes treatments before resorting to insulin, this may not be the best strategy. By the time a person with type 2 starts insulin therapy, they likely already have diabetes-related complication because of poor blood sugar control, Dr. Crandall says. Because high blood sugar is so toxic and can up the risk of heart attack, stroke, and other problems, you shouldnt waste too much time undergoing treatments that arent getting your blood sugar under control.In fact, starting insulin sooner may avoid complications, cause oral medications to work better , or allow you to use a less-complicated insulin regimen for a longer period of time.

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How To Start Taking Insulin

Your health care provider can start you on insulin in one of several ways: You may begin with a simple regimen, such as one injection of intermediate- or long-acting insulin at night, or a combination insulin, such as a 70 percent long-acting and 30 percent rapid-acting mixture, at breakfast and dinner. Mixtures in other ratios are also available. Individual insulins and combination insulins can be taken using vials and syringes or insulin pens. Using an insulin pen is easier to dose, potentially more accurate, and a more convenient way to carry your insulin.

“Talk frequently with your health care provider, and request guidelines for adjusting your insulin dose until you achieve blood glucose control,” says William Polonsky, Ph.D., CDE. Don’t wait three to six months between appointments to have your providers help you with adjusting your insulin dose. Eventually, you may need a more complex regimen that more closely mimics the way your pancreas releases insulin.

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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Store And Dispose Of Your Insulin And Needles Safely

Insulin you are not using should be stored in the door of your fridge. You can keep the insulin you are using out of the fridge for a month, as injecting insulin at room temperature is less painful.

Never put your used needles in the rubbish bin. Your GP or diabetes nurse can give you a container to put used needles in and can organise a place where you can dispose of the container once its full.