Elsevier Logo

English

ThisisPatientEngagementcontent

WHAT HAPPENS WHEN YOUR PATIENT GOES HOME?

Learn more about our Patient Engagement products now! Turn your patients into active participants in their healthcare by giving them easy access to the same evidence-based information you trust – but delivered in an easy-to-understand format.

Dec.01.2020
 Insulin Treatment for Diabetes Mellitus

Insulin Treatment for Diabetes Mellitus

Diabetes, also known as 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. With type 2 diabetes, you will have one or both of these problems:
    • Your pancreas does not make enough insulin.
    • Cells in your body do not respond properly to insulin that your 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 be given only 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 your 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 your belly button.
  • 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. Other people 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 different types of insulin are described below. Specifics vary depending on the insulin product that your health care provider prescribes.

Rapid-acting insulin:

  • Starts working quickly, within 15 minutes.
  • Can last for 4–5 hours.
  • 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 3–6 hours.
  • Should be taken about 30 minutes before you start eating a meal.

Intermediate-acting insulin:

  • Starts working in 2–4 hours.
  • Lasts for about 12–18 hours.
  • Lowers your blood glucose for a longer period of time. However, it does not work as well for lowering blood glucose right after a meal.

Long-acting insulin:

  • Mimics the small amount of insulin that your pancreas usually makes 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 be used only with the special U-500 syringe or U-500 insulin pen. Do not use another type of syringe with this insulin. The wrong type of syringe can cause serious problems.

What are the side effects of insulin?

Possible side effects of insulin treatment include:
  • Low blood glucose (hypoglycemia).
  • Weight gain.
  • Bruising or irritation at the injection site.
Some of these side effects can be caused by incorrect insulin doses and 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 you need to have in your body to keep your blood glucose levels stable. People who have type 1 diabetes need basal insulin in a nonstop (continuous) or steady dose 24 hours a day.
  • Usually, intermediate-acting or long-acting insulin is used one or two times a day to manage glucose 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 told to adjust the amount of prandial insulin that you take based on how much carbohydrate is in your meal.

Correction 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 told to check your blood glucose at certain times of the day and use correction 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.

Eating and drinking

  • Follow instructions from your health care provider about a healthy meal plan. Do not skip meals.
  • Drink enough fluid to keep your urine pale yellow.
  • Follow your sick day plan whenever you cannot eat or drink normally. Make this plan in advance with your health care provider.

Lifestyle

  • Work with your health care provider to manage your weight, blood pressure, cholesterol, and stress.
  • Exercise regularly.
  • Avoid drinking alcohol.
  • Avoid using any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.

General instructions

  • Check your blood glucose as told. Your health care provider will tell you how often and when you should check your blood glucose.
  • Make sure to check your blood glucose before and after you exercise. If you exercise longer or in a different way than usual, check your blood glucose more often.
  • Make sure you know the symptoms of high and low blood sugar and how to treat these.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Carry a medical alert card or wear medical alert jewelry.
  • Keep all follow-up visits as told by your health care provider. This is important.

Summary

  • Diabetes is a long-term disease. It occurs when the body does not properly use sugar (glucose) that is released from food after digestion. Glucose levels are controlled by insulin.
  • 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 as told by your health care provider. Your health care provider will tell you how often and when you should check your blood glucose.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

;