Keep in Mind Before Initiating Insulin

Insulin for diabetes

Insulin is a hormone that our body makes to keep blood glucose levels within a normal range. It is formed by the beta cells of the pancreas. If you don’t have enough insulin, glucose builds up in your bloodstream instead of entering your cells to provide energy.

In type 1 diabetes, the body does not make any insulin, so insulin must be given regularly every day to stay alive. In type 2 diabetes, the body does not make enough insulin, or the insulin that is made does not work well.

Store insulin properly

In general, you can store insulin at room temperature, opened or unopened, for ten to 28 days or longer. This depends on the type of pack, brand of insulin and how you inject it. You can also store insulin in the refrigerator or between 36 to 46°F (2 to 8°C). You can use unopened bottles that you have kept in the refrigerator until the printed expiration date. Your pharmacist is likely to be the best source of information on how to properly store insulin.

Here are some tips for proper storage:

• Always read labels and use open containers within the time recommended by the manufacturer.
• Never store insulin in direct sunlight, in the freezer, or near heating or air conditioning vents.
• Do not leave insulin in a hot or cold car.
• If you are traveling with insulin, use insulated bags to mitigate temperature changes.

Dosing — When you first start using insulin, it will take some time to find the right dose. Your doctor or nurse will help you adjust your dose over time. You will be instructed to check your blood sugar several times a day or use a continuous glucose monitor (CGM). Insulin needs often change throughout life. Changes in weight, diet (what you eat), health (including pregnancy), activity level and work can affect the amount of insulin needed to control blood sugar. Most people adjust their insulin dose on their own, although you may need help from time to time. Appointments with a member of your diabetes care team will usually be scheduled every three to four months; at these visits, you will check your blood sugar and insulin doses, which will help you fine-tune your diabetes control.

What is an insulin reaction?

If you will be using 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 work to find the right dose of this insulin, you may have some insulin reactions. Hypoglycemia is the name given to a condition where the blood sugar level is too low. If you use insulin, your blood sugar may drop too low if you exercise more than usual or if you don’t eat enough. It can also decrease too much if you don’t eat on time or if you take too much insulin. Most people who take insulin have insulin reactions at some point.

Starting on insulin

People with type 1 diabetes must inject insulin every day, often up to 4 or 5 times a day. They may use a pump to deliver the insulin, which means they insert a new cannula (a very fine plastic tube) under the skin every 2 to 3 days. Sometimes people with type 2 diabetes also need to start using insulin when diet, exercise and tablets no longer effectively control blood glucose levels. Having to start injecting insulin can be scary. There are various devices that can be used to easily administer insulin. The pen needles are very fine and so are the cannulas. People who need insulin often feel much better once they start taking insulin. If you need to start using insulin, your doctor or diabetes nurse educator can help with education and support. It will teach you about:

• the type and effect of your insulin
• how, where and when to inject insulin
• how to alternate injection sites
• where to get insulin and how to store it safely
• how to manage low blood glucose
• how to keep records of blood glucose levels and insulin doses
• which will help you adjust your insulin doses.

Insulin doses usually do not stay the same as your starting dose. Your doctor or diabetes nurse educator will help you adjust your insulin. An important part of insulin adjustment is regular monitoring and recording of blood glucose. Your insulin doses can change over time and for a variety of reasons, such as increased or decreased exercise, diet changes, medication, illness, weight gain or weight loss, so it’s important to see your diabetes management team regularly. When you start using insulin, it’s important to get checked by an accredited practicing dietitian to understand how carbohydrates and insulin work together. If you have type 1 diabetes, learning how to count your carbs and match your insulin with the food you eat is an ideal way to manage it. Therefore, depending on what you eat, your insulin doses during meals can vary from meal to meal and day to day.

Starting on insulin means:

• Your healthcare team has decided that this is the best way to help you manage your diabetes and will work with you to make sure you understand how using insulin fits into your diabetes management.
• You may be concerned about using a needle, but there are different ways to administer insulin, including insulin pens, syringes, inhalers and pumps. Your healthcare team can help you choose what works best for you and your lifestyle.
• You will need to learn new skills, such as learning how to give insulin, as well as how much and when.
• It takes time to learn how to adjust your insulin dose based on your blood glucose level. You may also need to check your blood glucose more often to learn how to adjust your insulin based on your blood glucose, food intake, and activity. As you gain experience and with the support of your healthcare team, you’ll better understand how food and physical activity affect your blood sugar and how to adjust your insulin to stay on target. Glucose monitoring is very helpful in adjusting insulin use.

Wrapping Up

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