Insulin: It’s A Good Thing. Really!
One of my nurse educator colleagues was recently featured in a teaching video on how to inject insulin. As part of the video, we asked people who have diabetes and who take insulin to answer some questions about what it’s like to have diabetes, including following a meal plan and injecting insulin. While a few of the people (two of them were young women) boldly stated that they disliked having to take insulin (or as one woman put, “poke herself”), all of them agreed that insulin was a good thing and that, if you need it, take it. As a dietitian, I’ve dealt mostly with the “food” end of diabetes, but of course, food and insulin are so closely intertwined that you really can’t talk about one without the other (and vice versa). More and more people have diabetes, as you’re aware, and more and more people are taking insulin. Now, you know that if you have Type 1 diabetes, you have to take insulin in order to live. Right now, there are no other options for treating Type 1. With Type 2 diabetes, things are a little murkier. Some people with Type 2 can manage just fine, at least for a while, by following a meal plan, controlling their weight, and getting regular exercise. Most people, though, are started off on a medicine (usually metformin), along with a meal plan and physical activity. After a few years, one or two more medicines (usually pills) are added. And then, after that, typically comes insulin. It’s at this stage where people beg, plead, cry, or yell to do anything to stay off of the dreaded “needle.” Why is this? Well, an obvious reason is that most of us don’t like needles. They can hurt. They’re sharp. They look long. But there are other reasons for not wanting to go on insulin, besides having to “take a needle.” I’ve listed some of Continue reading >>
Ada News: Insulin Is Safe, But Type 1's Still Faring Poorly
This is a good news + good news + bad news scenario, Folks. From announcements made at the ADA Conference in Philly, we've learned that long-term insulin use is shown to be safe — even Lantus use does not cause cancer risk! — but on the whole, type 1 diabetics in America aren't faring so well, health-wise. A huge and unprecedented study by the name of ORIGIN (Outcome Reduction with Initial Glargine Intervention) is the first-ever to investigate the risks of taking insulin on a long-term basis. Happily, researchers found that the risks are low! Daily injections "neither increased or reduced the risk of heart attacks, strokes, cancer or cardiovascular-related mortality." Albeit, this study was conducted on more than 12,500 patients either at risk for, or in the early stages of type 2 diabetes, but there's no reason to believe the results are not applicable to type 1s — the most likely folks to be taking insulin over loooong periods of time. "ORIGIN's findings should reassure patients and clinicians regarding the long-term health impact of using basal insulin therapy to target normoglycemia," said principal investigator Hertzel Gerstein of the McMaster University Department of Medicine in Ontario in a press statement. (Normoglycemia?! Is that an official medical term? Who cares? I love it!) Related European/U.S. studies counteract earlier claims that use of the long-acting insulin Lantus is related to cancer risk. Kaiser Permanente examined data from 115,000 patients using either Lantus or NPH, and found "no evidence of an increased risk for cancer ... and specifically no increased risk for breast cancer in the small group that stayed on these drugs for more than 24 months," according to principal investigator Til Sturmer of the Center for Excellence in Pharmacology Continue reading >>
Insulin And Type 2 Diabetes: What You Should Know
Insulin and Type 2 Diabetes If your health care provider offered you a medication to help you feel better and get your blood sugar under control, would you try it? If so, you might be ready to start taking insulin. Does insulin immediately make you think of type 1 diabetes? Think again. Between 30 and 40 percent of people with type 2 diabetes take insulin. In fact, there are more people with type 2 diabetes who take insulin than type 1 because of the much larger number of people with type 2. Experts believe even more people with type 2 should be taking insulin to control blood sugar -- and the earlier, the better. With an increase in people developing type 2 at a younger age and living longer, more and more people with type 2 will likely be taking insulin. "If you live long enough with type 2 diabetes, odds are good you'll eventually need insulin," says William Polonsky, Ph.D., CDE, associate clinical professor of psychiatry at the University of California, San Diego; founder and president of the Behavioral Diabetes Institute; and author of Diabetes Burnout: What to Do When You Can't Take It Anymore (American Diabetes Association, 1999). Producing Less Insulin Naturally Over Time Research has shown that type 2 diabetes progresses as the ability of the body’s pancreatic beta cells to produce insulin dwindles over time. Your beta cells -- the cells in the pancreas that produce insulin -- slowly lose function. Experts believe that by the time you're diagnosed with type 2 diabetes, you've already lost 50-80 percent of your beta cell function and perhaps the number of beta cells you had. And the loss continues over the years. "About six years after being diagnosed, most people have about a quarter of their beta cell function left," says Anthony McCall, M.D., Ph.D., endocri Continue reading >>
Is Insulin Safe For Patients With Diabetes Who Also Have Had A Heart Attack?
Question: Is insulin safe for patients who have had a heart attack? Answer: I think there are two aspects of insulin today as a treatment for people like yourself with diabetes. The first thing is, is that we do not believe today that insulin increases the risk of heart disease in diabetes, as was thought years ago. So that in an attempt to control the sugar component of diabetes and prevent blindness, and kidney disease, and amputations, and the nerve damage with diabetes, it was almost as if we were willing to accept this bump in the risk of heart disease along with that. We know now, in fact, that insulin is a very good drug to treat diabetes. It's not always required to treat patients with diabetes, but it is an excellent drug. And if you need it, and your doctor tells you you need it, you to get your sugar level down, you should accept it as your friend. Because reducing that sugar level is the best thing to reducing your risk of heart disease in the future as well as some of those other complications I mentioned. I might add that if you have a heart attack, maybe the best drug in the hospital to lower sugar right away is insulin. Because insulin can be given intravenously -- or under the skin – and it can get it to the body much quicker than a pill can to reduce the sugar level. Next: Should I Switch To Insulin Now That I Have Had A Heart Attack? Previous: What Can I Do About Dizziness That Comes With My Blood Pressure Medications? Continue reading >>
Taking Insulin During Pregnancy
When your blood glucose levels stay raised despite meal planning and physical activity, insulin must be added to your management plan to keep you and your baby healthy. Pregnancy requires that your body produce extra amounts of insulin. Insulin is a hormone that is made by the pancreas. If your pancreas does not make enough insulin, injections can help you meet the need. Your health care provider and diabetes educator will teach you how to inject insulin safely and comfortably. Determining the right insulin and dosage Tip Keep a record of the type and amount of insulin you take. It is important that you know and remember your insulin type every time you speak with a health care provider. Your health care provider will decide what kind of insulin is right for you, how much to use and when you should take it, based on: your weight (which changes weekly) how far along your pregnancy is your meal plan your most recent blood glucose levels Sometimes, you may need more than one type of insulin. Different types of insulin work at different speeds, and your health care provider may combine insulins to achieve the best results for you. Time-action of different insulins Insulins Starts working Peaks Stops working Rapid acting: Humalog® (lispro) NovoLog® (aspart) Apidra® (glulisine) 5 to 15 minutes 1 to 2 hours 2 to 4 hours Intermediate acting: NPH (N) 2 to 4 hours 4 to 8 hours 10 to 16 hours Basal*: Lantus® (glargine) Levemir® (detemir) 2 hours No peak 24 hours *Lantus® and Levemir® cannot be mixed with any other insulin. How to help insulin work best Take your insulin at the same times each day as directed. Talk with your health care provider if you feel sick. Follow any instructions your health care provider gives you. Don't change your meal plan, physical activity, pres Continue reading >>
Side Effects Of Taking Insulin When You Don't Need It
Insulin-dependent diabetics take insulin injections because their pancreas no longer produces insulin. Insulin helps cells absorb glucose, the body’s main energy source, from the blood. All Type 1 diabetics, formerly called juvenile diabetics, and some Type 2 diabetics, formerly called adult-onset diabetics, need insulin because their bodies no longer produce enough of the hormone. Without insulin to remove glucose from the blood, blood glucose levels rise, a condition called hyperglycemia. Taking too much insulin or taking insulin when your body already makes enough removes too much glucose from the blood, a condition called hypoglycemia, or low blood sugar. Video of the Day All cells require glucose to function. When you eat, carbohydrates in the food break down in the intestines into glucose. The blood absorbs the glucose. When this happens, your blood glucose levels rise. In response to the increase in blood sugar, the pancreas releases insulin. Insulin facilitates a cell’s ability to remove glucose from the blood and utilize it for energy. If your body has already released enough insulin and you take more, too much glucose is removed from your blood and you become hypoglycemic. Taking an overdose of short-acting or intermediate-acting insulin is more dangerous than taking too much long-acting insulin, eMedTV explains. Taking insulin when you don’t need it causes symptoms such as sweating, shaking, headache, irritability, nervousness, anxiety, weakness, dizziness, hunger, tremors, nausea, and difficulty concentrating or thinking. For diabetics, the treatment for hypoglycemia is to eat something containing quickly absorbed glucose, such as candy or special glucose tablets. If you have a hypoglycemic reaction and take glucose, follow up with a snack containing b Continue reading >>
Is Insulin Safe For Controlling Blood Sugar Level?
Answered by: Prof Dinesh Dhanwal | Prof of Medicine and Head of Endocrinology, Maulana Azad Medical College, New Delhi Q: My relative is 42 years old. He was diagnosed with diabetes three years back. He is taking oral drug Glipizide 250 mg twice a day. For the past three months, his sugar level is not under control. The fasting sugar level was 168 mg/dl three months back but shot up to 204 mg/dl few days back. We are asking him to go for insulin injections. Is it safe to take insulin injections at his age? Are there any side effects of taking insulin? Also, will he be able to lead a normal life after taking these injections, i.e. will his sugar level become normal? Kindly let us know the brands under which insulin is available and the amount of insulin that he should take. And lastly, can he revert to taking oral drugs after his sugar level is controlled? A:Your relative has type 2 diabetes mellitus (DM). Most importantly, one has to keep in mind while treating DM is glucose control, which means keeping FBG <130 mg/dl and PPBG <160 mg/dl. Another test that which can be done to assess glycaemic control is HBA1c levels, which tells glucose control in last three months. The target value for this test is <7. The primary issue is to get these targets, and how one gets these is secondary. Options to treat and get these targets are oral medications either as single agent or in combination or insulin alone or in combination with oral medications. Insulin can be given at any age and has no harmful effects as it is a normal requirement of the body and many of oral medications act by increasing insulin in our body. Options of insulin are either premixed twice daily or oral medication with basal 24 hours acting insulin like glargine (Lantus) or Insulin Detimir (Levimir). In case of Continue reading >>
What Are The Side Effects Of Insulin Shots?
Insulin is at the center of the diabetes problem. In people with type 2 diabetes, the body does not use insulin effectively. The pancreas compensates by overproducing insulin, and in time, it simply cannot keep up with the demands of the body to keep glucose levels down. To provide enough insulin to the body to manage blood glucose levels, many diabetics are advised to take insulin shots. The insulin in these injections is a chemical that is produced artificially to resemble the insulin made in our pancreas. This insulin works just like natural insulin by escorting sugar from our blood into our cells. Type 2 diabetics deal with a condition known as insulin resistance. It is a phenomenon where cells aren’t sensitive to the action of insulin (escorting blood glucose into cells) and hence, do not respond to it. This leads to the accumulation of glucose in the blood and is called hyperglycemia. Supplemental insulin given to Type 2 diabetics helps the body ‘muscle’ sugar out of the bloodstream and into cells. Insulin injections are used to regulate blood sugar differently for the different diabetes-types: For people who have type 1 diabetes – Their bodies cannot make insulin and therefore they aren’t able to regulate the amount of glucose in their bloodstream. For people who have type 2 diabetes – Their bodies aren’t able to produce enough insulin, or use it effectively. The insulin shots are used because the blood sugar cannot be regulated with oral medications alone. They also stop the liver from producing more sugar. Every type of insulin available in a drug store works in this way. They, mainly, differ in two ways – How quickly they begin to work For how long they can regulate blood sugar levels Mechanism of Action Regulating the process in which glucose Continue reading >>
Is It Safe To Take Insulin That Has Frozen?
Now playing: Is it safe to take insulin that has frozen? Photographs are being used for illustrative purposes only. The people depicted in the licensed material are models. Important! Information presented is not a substitue for professional medical advice. tell me more Insulin freezes almost as easily as water, and can be damaged by too much heat, so it's important to keep it protected from the elements. Once it's been opened, you can keep your insulin at room temperature for one month. Using insulin that's been frozen is dangerous, because if the protein has been damaged, it could mean you're not getting an adequate dose. Continue reading >>
Expert Advice: 18 Questions About Taking Insulin
Stuart Weiss, MD, is a clinical assistant professor of endocrinology, diabetes, and metabolism at New York University's Department of Medicine, NYU Medical Center, in New York City. Q: I have type 2 diabetes. Do I have to take insulin? A: For people with type 2 diabetes, insulin is a very nice tool that's better if used sooner rather than later. (Unlike in type 2 diabetes, in type 1 diabetes insulin is a requirement, not an option.) What happens in type 2 diabetes is that physicians may use insulin as a threat, an “if you” thingif you don't lose some weight, if you don't do some exercise, if you don't follow the diet, then you're going to wind up on insulin. That's really not how people with type 2 diabetes should view insulinas a punishment. Insulin is a very, very safe therapy, and people should not hesitate to use it if needed. The people with type 2 diabetes who must take insulin are those who are unable to control their blood sugar even while on several different oral medications. But if you start using insulin before you reach that point, you can help preserve the function of your insulin-producing pancreatic cells for a longer time. And the longer you continue to make your own natural insulin, the longer you can get by with a less complicated insulin regimen, possibly taking just one shot a day. Q: But I'm afraid of shots! A: You don't need to be, if you're talking about insulin. If you're picturing big syringes that you have to boil and sterilize, think again. Modern insulin needles are very thin and disposableno sterilizing necessary. There are also insulin pens equipped with an insulin cartridge and disposable needles that are so simple even a child can use them. Either type of delivery system makes using insulin very easy and virtually painlessreally. If Continue reading >>
Insulin Safety Center
Why an Insulin Safety Center? The Insulin Safety Center is a unique resource dedicated entirely to medication error prevention with the use of insulin. Insulin is an essential and lifesaving drug safely used by millions of Americans every year. Insulin enables individuals with diabetes to lead a healthy lifestyle. However, insulin use is associated with some risks and any misuse can cause harm or even death. Insulin is considered a "high-alert medication" by the Institute for Safe Medication Practices. High alert medications have been proven to be safe and effective when taken according to instructions approved by your healthcare provider. But, they are more likely to cause injury or even death if a mistake happens while taking them. This means that it is critically important for you to know about this medicine and how to take it exactly as prescribed by your healthcare provider or explained to you by your pharmacist. In addition to insulin being considered a high-alert medication, insulin has also been known to be associated with more medication errors than most other medicines. The Institute for Safe Medication Practices performed a safety study on drug use in hospitals and found that 11% of all serious drug errors involved insulin misadministration. Another recent study at four U.S.A. poison centers looked at calls taken over the past 10 years. They found that calls about insulin concerns have "skyrocketed." On average, the number of calls per year has almost tripled since 2002. This Insulin Safety Center is a great place to access information regarding all aspects of safe insulin use. Here you will learn all about the most frequent types of errors associated with insulin use. In addition, you will see how these errors can occur and what you and your caregivers can d Continue reading >>
Is It Ok To Take Insulin For Gestational Diabetes?
Eating healthy foods and getting plenty of exercise may be all you need to control your blood sugar levels during your pregnancy. But when that's not enough, you may need to take insulin, too. Insulin is a hormone that helps your cells take in and use glucose. Your pancreas makes insulin, but the kind you take is made in a lab. Your doctor may prescribe it when your body doesn't make enough on its own to keep your blood sugar levels in a normal range. That will help prevent problems for you and your baby. Insulin doesn't cross the placenta, which means it can't get to your baby, so it's safe to use as prescribed. Taking Insulin You inject it under your skin with a syringe or insulin pen. You can't take insulin as a pill or drink it. How much you'll need and how often you'll need it will probably change during your pregnancy. Some kinds of insulin work in just a few minutes; others work more slowly but last longer. You take fast-acting insulin with a meal, so it goes to work right away to help your body use the glucose from the food you ate. Your doctor will probably prescribe this type, along with one that lasts about 12 hours or overnight. Longer-acting (24-hour) insulin hasn't been studied with pregnant women. What to Watch For You might get sore and have hard lumps where you inject the insulin. To prevent this, try not to give yourself the shot in the same place every time. Insulin can also cause low blood sugar (hypoglycemia) when there's not enough glucose in your blood for your body to work right. You're more likely to have this if you skip a meal or use too much insulin. Be sure you know the warning signs: dizziness, sweating, shaking, and blurry vision. The best treatment is a quick-sugar food like raisins, honey, or glucose tablets or gel. Low blood sugar can b Continue reading >>
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Is Insulin Safe At Room Temperature?
We research whether it’s safe to use insulin in the fridge after a power outage. An Insulin Nation reader who experienced a power outage recently asked whether the insulin in his fridge was still safe to use. In the aftermath of Hurricanes Harvey and Irma, we thought this might be a good time to share a short primer about the subject. sponsor We asked certified diabetes educator Gary Scheiner of Integrated Diabetes Services about this, and he said that modern insulin formulations are designed so that vials can be stable at room temperature for close to a month. ConsumerMedSafety.org also states that an open vial of insulin is good at room temperature for 28 days. Thanks for reading this Insulin Nation article. Want more Type 1 news? Subscribe here. Unfortunately, that doesn’t cover every situation when the power goes out. Room temperature is generally agreed upon to be roughly in the range of 59 degrees fahrenheit to 77 degrees fahrenheit. Colder temperatures and hotter temperatures can diminish the effectiveness of the insulin; freezing temperatures can ruin insulin. (Also, be careful to keep insulin away from direct sunlight if you store it outside the fridge.) If you come home to a power outage after time away from home, you might have to do some detective work to determine whether the temperature of the room likely strayed from that “room temperature” range. In Texas and Florida, once the AC goes down, high temperatures could be very likely. sponsor A fridge’s insulation can help slow what’s inside from becoming the same temperature as the room for a while; Foodsafety.gov says most fridges can keep what’s inside cool for four hours, while a full freezer will keep things cool for roughly 48 hours. Keep in mind that not every fridge has the same amount o Continue reading >>
Using Insulin Safely
Insulin is a lifesaving drug in diabetes. It can also be a dangerous drug, if misused. Do you know how to use insulin safely? Taking too much insulin can cause low blood sugar or hypoglycemia, which can cause fainting, seizures, or even death. How careful are you to give yourself the right amount? Here are some things that can go wrong. For people who are on two insulins, a long-acting basal and a rapid-acting insulin for meals, theres a danger of mixing them up. If you give the wrong one, you could be at risk for serious hypos. Drs. Patrick J. OConnor, MD, MPH, JoAnn M. Sperl-Hillen, MD, and diabetes educator Becky Klein, RN, CDE, recommend on Diabetes Self-Management ways to avoid this confusion . Keep your rapid-acting and long-acting insulins in consistent and different locations. Mark your vials or pens in some way so its clear which is which. Note whether one of your insulins is cloudy and one clear and remember and write down which is which. Use a pen for one type of insulin and syringes and a vial for the other. Since rapid-acting insulin is taken before meals, it makes sense to keep rapid-acting insulin on a kitchen table or counter. Since basal insulin is usually taken at bedtime or on awakening, its logical to keep long-acting insulin on a bedside table. You can use masking tape labels on pens to say Basal or Bolus (mealtime). If you take small doses, you can also write the date opened on a pen to remind you when it needs to be discarded. People also forget shots and dosages. Joyce Larson suggested : Set alarms on your phone to remind you when to take a shot. Have a list of your insulin amounts near where you keep the insulin as a reminder. Linda Donaldson recommends that if you inject with syringes several times a day, you can take out the number of syringe Continue reading >>
Insulin For Type 2 Diabetes: When, Why, And How
Blood sugar control is one of the most important parts of type 2 diabetes management. Although you may be able to treat the condition at first with oral medication and lifestyle changes, such as exercise and weight loss, most people with type 2 diabetes eventually need to take insulin by injection. "There are several scenarios in which insulin treatment should start, including in patients with significant hyperglycemia who are symptomatic," explained Alaleh Mazhari, DO, an associate professor of endocrinology at Loyola Medicine in Maywood, Illinois. "In these cases, the need for insulin may be short-term. Other situations include patients who are on multiple diabetic medications with uncontrolled diabetes, and uncontrolled diabetes in pregnancy, to name a few." Here's what you need to know about taking insulin in the short term and the long term. Insulin for Short-Term Blood Sugar Control 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. "The American Association of Clinical Endocrinologists recommends starting a person with type 2 diabetes on insulin if their A1C is above 9 percent and they have symptoms," said Mazhari. Symptoms of type 2 diabetes include thirst, hunger, frequent urination, and weight loss. Research published in February 2013 in the journal The Lancet Diabetes & Endocrinology reviewed several studies that focused on the temporary use of insulin to restore sugar control in people with type 2 diabetes. The results showed that a two- to five-week course of short-term intensive insulin therapy (IIT) can induce remission in patients Continue reading >>
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