Insulin: Friend or Foe?
Diabetes is a chronic progressive condition. Depending on how long one has been treated for diabetes, oral medications (pills) sometimes lose their ability to control blood sugar. Insulin is very effective at reducing blood sugars and there is a large amount of research that has made it clear that well controlled blood sugars reduce the risk of long term diabetes complications such as kidney, vision, nerve and heart disease. There are multiple types of insulin available so that each patient is able to have a customized regimen that will be effective in improving their blood sugar control.
1. Insulin causes complications. This is not true. Often patients start insulin later than is ideal and unfortunately complications are already underway.
2. If you need insulin your diabetes is really serious! Insulin is simply another tool to manage your condition. Any high blood sugar is serious and insulin is available for control.
3. My doctor told me if I ate a healthy diet, lost weight and exercised I would stay off insulin. What happened? Sometimes weight loss and healthy behaviors can improve diabetes control. However, diabetes is a progressive condition and often despite the best self-management, insulin is required to improve control.
4. Once I start insulin I will be on it forever. Not necessarily. Diabetes control is dynamic and sometimes insulin is no longer needed. However, very often patients choose to stay on insulin because they feel better and it is the most effective way to keep blood sugars controlled.
5. Insulin causes weight gain. It is true that sometimes patients who begin insulin gain weight. Insulin helps your body use food more efficiently. Following a meal plan, an exercise program and working with your health care team can help keep you from gaining excess weight.
6. Taking insulin injections will be painful. Many patients are surprised when they finally see how small and thin the needle actually is. In addition, many insulins come in insulin pens that make taking insulin simpler and more convenient.
How insulin works
- Supplements insulin when the body is unable to make insulin (Type 1) or, when more insulin is needed than the body can produce (Type 2)
- Helps our bodies to use the glucose that comes from the foods we eat
- Helps to control high blood sugar
Guidelines for use
- Inject once or multiple times each day; it varies based on the type of insulin you are using
- Your doctor or diabetes educator can coach you on the specific times for the insulin that is right for you
- Consume alcohol with caution; drinking alcohol while taking insulin may cause low blood sugar
- Dosage adjustments may be necessary for people who take insulin
What to do if a dose is forgotten
- Depending on the type of insulin you are taking you may be able to take the injection within an hour (long acting insulins) or you may need to skip the dose (short acting insulins)
- Do not take 2 doses the next time
- Infection at injection site (rare)
- Allergic reaction (rare)
Who should NOT take this medication
- Caution should be taken if you have any health issues which make it difficult to recognize or treat hypoglycemia
- Very rarely there is an allergy to newer insulins.
Insulin action times
Insulin delivery systems
Syringes are hollow barrels that have hypodermic needles attached. They are used to inject insulin. Insulin syringes are small with very small needles. Most have a special coating to help the needles enter the skin as painlessly as possible. Insulin syringes come in several different sizes to match insulin strength and dosage.
Insulin pens look like pens with cartridges - but the cartridges are filled with insulin rather than ink. They can be used instead of syringes for giving insulin injections. Some pens use replaceable cartridges of insulin; other models are totally disposable after the pre-filled cartridge is empty. A fine short needle, like the needle on an insulin syringe, is screwed on to the tip of the pen. Users turn a dial to select the desired dose of insulin and press a plunger on the end to deliver the insulin just under the skin.
Insulin pumps are small pumping devices worn outside of your body. They connect by flexible tubing to a catheter that is located under the skin of your abdomen. You program the pump to dispense the necessary amount of insulin. Usually, you set the pump to give a steady small dose of insulin, but you can give an additional amount in a short time if needed, such as before or after a meal. If adjusted properly, these pumps allow close control of your insulin levels without multiple injections. You still need to monitor your blood glucose levels regularly if you use this type of device.