Insulin Treatment for Diabetes Mellitus

Insulin Treatment for Diabetes Mellitus

Diabetes (diabetes mellitus) is a long-term (chronic) disease. It occurs when the body does not properly use sugar (glucose) that is released from food after digestion. Glucose levels are controlled by a hormone called insulin. Insulin is made in the pancreas, which is an organ behind the stomach.

  • If you have type 1 diabetes, you must take insulin because your pancreas does not make any.
  • If you have type 2 diabetes, you might need to take insulin along with other medicines. In type 2 diabetes, one or both of these problems may be present:
    • The pancreas does not make enough insulin.
    • Cells in the body do not respond properly to insulin that the body makes (insulin resistance).

You must use insulin correctly to control your diabetes. You must have some insulin in your body at all times. Insulin treatment varies depending on your type of diabetes, your treatment goals, and your medical history. Ask questions to understand your insulin treatment plan so you can be an active partner in managing your diabetes.

How is insulin given?

Insulin can only be given through a shot (injection). It is injected using a syringe and needle, an insulin pen, a pump, or a jet injector. Your health care provider will:

  • Prescribe the type and amount of insulin that you need.
  • Tell you when you should inject your insulin.

Where on the body should insulin be injected?

Insulin is injected into a layer of fatty tissue under the skin. Good places to inject insulin include:

  • Abdomen. Generally, the abdomen is the best place to inject insulin. However, you should avoid any area that is less than 2 inches (5 cm) from the belly button (navel).
  • Front of thigh.
  • Upper, outer side of thigh.
  • Upper, outer side of arm.
  • Upper, outer part of buttock.

It is important to:

  • Give your injection in a slightly different place each time. This helps to prevent irritation and improve absorption.
  • Avoid injecting into areas that have scar tissue.

Usually, you will give yourself insulin injections. Others can also be taught how to give you injections. You will use a special type of syringe that is made only for insulin. Some people may have an insulin pump that delivers insulin steadily through a tube (cannula) that is placed under the skin.

What are the different types of insulin?

The following information is a general guide to different types of insulin. Specifics vary depending on the insulin product that your health care provider prescribes.

  • Rapid-acting insulin:
    • Starts working quickly, in as little as 5 minutes.
    • Can last for 4–6 hours (or sometimes longer).
    • Works well when taken right before a meal to quickly lower your blood glucose.
  • Short-acting insulin:
    • Starts working in about 30 minutes.
    • Can last for 6–10 hours.
    • Should be taken about 30 minutes before you start eating a meal.
  • Intermediate-acting insulin:
    • Starts working in 1–2 hours.
    • Lasts for about 10–18 hours.
    • Lowers your blood glucose for a longer period of time, but it is not as effective for lowering blood glucose right after a meal.
  • Long-acting insulin:
    • Mimics the small amount of insulin that your pancreas usually produces throughout the day.
    • Should be used one or two times a day.
    • Is usually used in combination with other types of insulin or other medicines.
  • Concentrated insulin, or U-500 insulin:
    • Contains a higher dose of insulin than most rapid-acting insulins. U-500 insulin has 5 times the amount of insulin per 1 mL.
    • Should only be used with the special U-500 syringe or U-500 insulin pen. It is dangerous to use the wrong type of syringe with this insulin.

What are the side effects of insulin?

Possible side effects of insulin treatment include:

  • Low blood glucose (hypoglycemia).
  • Weight gain.
  • High blood glucose (hyperglycemia).
  • Skin injury or irritation.

Some of these side effects can be caused by using improper injection technique. Be sure to learn how to inject insulin properly.

What are common terms associated with insulin treatment?

Some terms that you might hear include:

  • Basal insulin, or basal rate. This is the constant amount of insulin that needs to be present in your body to keep your blood glucose levels stable. People who have type 1 diabetes need basal insulin in a steady (continuous) dose 24 hours a day.
    • Usually, intermediate-acting or long-acting insulin is used one or two times a day to manage basal insulin levels.
    • Medicines that are taken by mouth may also be recommended to manage basal insulin levels.
  • Prandial or nutrition insulin. This refers to meal-related insulin.
    • Blood glucose rises quickly after a meal (postprandial). Rapid-acting or short-acting insulin can be used right before a meal (preprandial) to quickly lower your blood glucose.
    • You may be instructed to adjust the amount of prandial insulin that you take, based on how much carbohydrate (starch) is in your meal.
  • Corrective insulin. This may also be called a correction dose or supplemental dose. This is a small amount of rapid-acting or short-acting insulin that can be used to lower your blood glucose if it is too high. You may be instructed to check your blood glucose at certain times of the day and use corrective insulin as needed.
  • Tight control, or intensive therapy. This means keeping your blood glucose as close to your target as possible, and preventing your blood glucose from getting too high after meals. People who have tight control of their diabetes have fewer long-term problems caused by diabetes.

Follow these instructions at home:

Talk with your health care provider or pharmacist about the type of insulin you should take and when you should take it. You should know when your insulin goes up the most (peaks) and when it wears off. You need this information so you can plan your meals and exercise. Work with your health care provider to:

  • Check your blood glucose every day. Your health care provider will tell you how often and when you should do this.
  • Manage your:
    • Weight.
    • Blood pressure.
    • Cholesterol.
    • Stress.
  • Eat a healthy diet.
  • Exercise regularly.

Summary

  • Diabetes is a long-term (chronic) disease. It occurs when the body does not properly use sugar (glucose) that is released from food after digestion. Glucose levels are controlled by a hormone called insulin, which is made in an organ behind your stomach (pancreas).
  • You must use insulin correctly to control your diabetes. You must have some insulin in your body at all times.
  • Insulin treatment varies depending on your type of diabetes, your treatment goals, and your medical history.
  • Talk with your health care provider or pharmacist about the type of insulin you should take and when you should take it.
  • Check your blood glucose every day. Your health care provider will tell you how often and when you should check it.
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