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. Every person with diabetes being treated with insulin should be trained by a health care professional. This training should include the different injection steps, as well as the treatment and prevention of hypoglycemia, which can occur in anyone on insulin. Medication and insulin More topics.
Starting insulin treatment should not be seen as a setback. Search Enter a word and discover the content associated with it. Doctors use a blood test called a hemoglobin A1C test to measure average blood sugar control over a two- to three-month period.
The treatment target for most people with diabetes is an A1C of 7 percent or less; those with higher levels may need a more intensive medication plan.
Symptoms of type 2 diabetes include thirst, hunger, frequent urination , and weight loss. The results showed that a two- to five-week course of short-term intensive insulin therapy IIT can induce remission in patients who are early in the course of type 2 diabetes. At three months after stopping the IIT, 66 percent of patients were still in remission, and at six months, 59 percent were still in remission.
They may have been on one, two, or three diabetes medications , but their A1C can no longer be kept in a safe range. Type 2 diabetes is a progressive disease, so treatment plans will change. When it's not possible to meet blood sugar control goals with lifestyle changes or other medication, insulin is the next step. The change can have upsides, particularly for patients who have been on a complicated regimen of three or four drugs, with lots of side effects. Changing to insulin can actually be a lot better.
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.
Insulin pumps are attached to your body and can be programmed to administer rapid-acting insulin throughout the day, to cover both basal and prandial insulin needs. Inhaled insulin is ultra-rapid acting insulin and can replace insulin used for mealtime and corrections of high glucose. It is taken through an inhaler and works similarly to injected prandial insulin.
The only approved inhaled insulin on the market is the ultra-rapid-acting mealtime insulin Afrezza. Your insulin regimen should be tailored to fit your needs and lifestyle. Adjusting your basal insulin dosage and timing will require conversations and frequent follow-up with your healthcare team.
When initiating insulin therapy, you may be advised to start with a low dose and increase the dose in small amounts once or twice a week, based on your fasting glucose levels. Insulin may be used alone or in combination with oral glucose-lowering medications, such as metformin, SGLT-2 inhibitors, or GLP-1 agonists.
One of the most important things to consider is the characteristics of different insulin types. In order to dose insulin to cover meals or snacks, you have to take a few factors into consideration. Your healthcare team should help you determine what to consider when calculating an insulin dose. Prandial insulin doses will usually be adjusted based on:. Current blood sugar levels. Insulin sensitivity factor ISF or correction factor: how much one unit of insulin is expected to lower blood sugar.
Your ISF may change throughout the day — for example, many people are more insulin resistant in the morning, which requires a stronger correction factor. Carbohydrate intake. Insulin to carb ratios represent how many grams of carbohydrates are covered by one unit of insulin. You should calculate your carbohydrate consumptions for each meal. For example, a insulin to carbohydrate ratio means one unit of insulin will cover every 10 grams of carbohydrates that you eat.
For a meal with 30 grams of carbohydrates, a bolus calculator will recommend three units of insulin. Physical activity. Adjust insulin doses before, and possibly after, exercise — learn more about managing glucose levels during exercise here. Learning to adjust your own insulin doses may be overwhelming at first, especially given the many factors that affect your glucose levels.
Identifying patterns in your glucose levels throughout the day may help you optimize the timing and dosing of your insulin. Your healthcare professional, a certified diabetes care and education specialist, or insulin pump trainer if you use a pump , can help guide you through this process.
Do not adjust your insulin doses without first talking to your healthcare team. The frequency of testing will depend on your health status and activities during the day. Initially, you may be advised to check your blood glucose three to four times a day.
As a starting point, check in with your healthcare team about how often to check your blood sugar. Many people test before meals, exercise, bedtime, and one to two hours after meals to ensure that they bolused their insulin correctly. Over time, your fasting, pre-meal, and post-meal blood glucose levels will help you figure out how to adjust your insulin doses.
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