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When Should Diabetics Take Insulin?

Insulin Therapy

Insulin Therapy

Why do I need to take insulin? When you digest food, your body changes most of the food you eat into glucose (a form of sugar). Insulin allows this glucose to enter all the cells of your body and be used as energy. When you have diabetes, your body doesn’t make enough insulin or can’t use it properly, so the glucose builds up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems. All people who have type 1 diabetes and some people who have type 2 diabetes need to take insulin to help control their blood sugar levels. The goal of taking insulin is to keep your blood sugar level in a normal range as much as possible so you’ll stay healthy. Insulin can’t be taken by mouth. It is usually taken with injections (shots). It can also be taken with an insulin pen or an insulin pump. How often will I need to take insulin? You and your doctor will develop a schedule that is right for you. Most people who have diabetes and take insulin need at least 2 insulin shots a day for good blood sugar control. Some people need 3 or 4 shots a day. Do I need to monitor my blood sugar level? Yes. Monitoring and controlling your blood sugar is key to preventing the complications of diabetes. If you don’t already monitor your blood sugar level, you will need to learn how. Checking your blood sugar involves pricking your finger to get a small drop of blood that you put on a test strip. You can read the results yourself or insert the strip into a machine called an electronic glucose meter. The results will tell you whether or not your blood sugar is in a healthy range. Your doctor will give you additional information about monitoring your blood sugar. When should I take insulin? You and your doctor should discuss when and how you Continue reading >>

Should I Use Diabetes Pills Or Insulin?

Should I Use Diabetes Pills Or Insulin?

Diabetes affects the way your body breaks down food. Treatment depends on which type of diabetes you have. In type 1 diabetes, your pancreas stops producing insulin. Insulin is a hormone that helps regulate glucose, or sugar, in your blood. Type 2 diabetes starts with insulin resistance. Your pancreas no longer produces enough insulin or doesn’t use it efficiently. Every cell in your body uses glucose for energy. If insulin isn’t doing its job, glucose builds up in your blood. This causes a condition called hyperglycemia. Low blood glucose is called hypoglycemia. Both can lead to serious complications. A variety of pills are available to treat diabetes, but they can’t help everyone. They only work if your pancreas still produces some insulin. They can’t treat type 1 diabetes. They aren’t effective in people with type 2 diabetes when the pancreas has stopped making insulin. Some people with type 2 diabetes can benefit from using both pills and insulin. Some pills to treat diabetes include: Biguanides Metformin (Glucophage, Fortamet, Riomet, Glumetza) is a biguanide. It lowers the amount of glucose in your liver and boosts insulin sensitivity. It may also improve cholesterol levels and might help you lose a little weight. People normally take it twice per day with meals. You can take the extended-release version once per day. Potential side effects include: upset stomach nausea bloating gas diarrhea a temporary loss of appetite It may also cause lactic acidosis in people with kidney failure, but this is rare. Sulfonylureas Sulfonylureas are fast-acting medications that help the pancreas release insulin after meals. They include: People usually take these medications once per day with a meal. Potential side effects include: irritability low blood glucose upset st Continue reading >>

Exercising Safely With Diabetes

Exercising Safely With Diabetes

Regular and safe physical activity is especially important for people with diabetes. Blood Sugar and Exercise The most common concern people have about exercise and diabetes is how to keep their blood sugar levels from getting too high or too low. Here are some general guidelines to follow: Exercise at the same time every day, if possible. This will help you find out how exercise affects your blood sugar. Check your blood sugar before exercising. If your blood sugar is less than 100 before you start to exercise, eat a carbohydrate snack. If your blood sugar is 250 or higher, don't start exercising until your blood sugar level is under 250. Exercise with a friend who knows that you have diabetes and knows how to help if your blood sugar gets too low. Make sure you have ID with you that lets people know you have diabetes. If you're sick or have an infection, don't exercise until you're feeling better. Being sick affects your blood sugar. Taking insulin or diabetes pills to lower blood sugar Blood sugar can go too low (hypoglycemia) during exercise if you take too much insulin, the insulin is absorbed too quickly, or the insulin peaks during exercise. It can also happen if you take insulin or pills and don't eat enough carbohydrate. Here are some things you can do: If your blood sugar is less than 100 before you exercise, eat at least 30 grams of carbohydrate before you begin. This will help keep your blood sugar level from dropping too low during exercise. Bring a carbohydrate snack with you whenever you exercise in case your blood sugar level drops too low during or right after you exercise. If your exercise will last for more than an hour, check your blood sugar after each hour of exercise. If your blood sugar is 100 or less, you should eat a carbohydrate snack. Check y Continue reading >>

12 Myths About Insulin And Type 2 Diabetes

12 Myths About Insulin And Type 2 Diabetes

Insulin facts vs. fiction When you hear the word “insulin,” do you picture giant needles (ouch!) or pop culture portrayals of insulin users with low blood sugar (like Julia Roberts losing it in Steel Magnolias)? Either way, most people think of insulin as a difficult, painful, or potentially scary medical treatment. The problem is that if you have type 2 diabetes, you need to know the real deal before you can make an informed choice about whether or not this potentially lifesaving therapy is right for you. Here, we take a look at the facts and fiction about insulin when it comes to treating type 2 diabetes. Diabetics always need insulin Not necessarily. People with type 1 diabetes (about 5% to 10% of diabetics) do need insulin. If you have type 2, which includes 90% to 95% of all people with diabetes, you may not need insulin. Of adults with diabetes, only 14% use insulin, 13% use insulin and oral medication, 57% take oral medication only, and 16% control blood sugar with diet and exercise alone, according to the CDC. The point is to get blood sugar—which can be a highly toxic poison in the body—into the safe zone by any means necessary. Taking insulin means you’ve ‘failed’ “This is a big myth,” says Jill Crandall, MD, professor of clinical medicine and director of the diabetes clinical trial unit at the Albert Einstein College of Medicine, in the Bronx, N.Y. “Many people who try very hard to adhere to a diet, exercise, and lose weight will still need insulin.” The fact is that type 2 diabetes is a progressive illness, meaning that over time you may need to change what you do to make sure your blood sugar is in a healthy range. Eating right and exercise will always be important, but medication needs can vary. “A large percentage of people with ty Continue reading >>

Diabetes Mellitus - Insulin Treatment In Dogs

Diabetes Mellitus - Insulin Treatment In Dogs

By Ernest Ward, DVM & Robin Downing, DVM, DAAPM, DACVSMR, CVPP Emergency Situations, Medical Conditions This handout provides detailed information on insulin administration. For more information about diabetes mellitus, see the fact sheets "Diabetes Mellitus - General Information", and "Diabetes Mellitus - Principles of Treatment". What is diabetes mellitus? In dogs, diabetes mellitus is caused by the failure of the pancreas to produce enough insulin to regulate blood sugar. This is Insulin Dependent Diabetes Mellitus (also called Type 1 Diabetes). This type of diabetes usually results from destruction of most or all of the beta-cells that produce insulin in the pancreas. As the name implies, dogs with this type of diabetes require insulin injections to stabilize blood sugar levels. What do I need to know about insulin treatment for diabetes mellitus? In diabetic dogs, the main treatment for regulating blood glucose is giving insulin by injection. Dogs with diabetes mellitus typically require two daily insulin injections as well as a dietary change. Although the dog can go a day or so without insulin and not have a crisis, this should not be a regular occurrence; treatment should be looked upon as part of the dog's daily routine. This means that you, as the dog's owner, must make both a financial commitment and a personal commitment to treat your dog. If are out of town or go on vacation, your dog must receive proper treatment in your absence. Initially, your dog may be hospitalized for a few days to deal with any immediate crisis and to begin the insulin regulation process. For instance, if your dog is so sick that he has quit eating and drinking for several days, he may be experiencing “diabetic ketoacidosis,” which may require a several days of intensive care. On Continue reading >>

Facts About Insulin Treatment

Facts About Insulin Treatment

Insulin is an essential hormone. Without it, the body cannot control or properly use glucose (sugar) – one of its main energy supplying fuels. How does insulin help diabetes? People with type 1 diabetes produce inadequate amounts of insulin, so insulin replacement is their key treatment. Without adequate insulin replacement, people with type 1 diabetes will see their blood sugar levels rise and the body will start to burn up its fat stores. In a few days this leads to a condition called diabetic acidosis, which is life threatening. Too much insulin, on the other hand, leads to such low levels of blood sugar that it causes a condition called hypoglycaemia. The symptoms include paleness, shaking, shivering, perspiration, rapid heartbeat, hunger, anxiety and blurred vision. In some cases it can cause loss of consciousness (hypoglycaemic coma) and convulsions. In type 2 diabetes the problem is not a lack of insulin output, but increasing resistance of your cells to the effects of insulin. In the early years, the body compensates for this insulin resistance by increasing the output of insulin from the pancreas gland. Ultimately, the pancreas becomes unable to cope. About 30 per cent of people with type 2 diabetes eventually need treatment with insulin. The longer a person has type 2 diabetes, the more likely they will have to start insulin treatment at some point. There are four main kinds of injectable insulin. The type of insulin you use will depend on your individual needs and lifestyle. Rapid-acting insulin analogues start working within 10 or 15 minutes and last between 2 to 4 hours. Examples are insulin aspart, insulin aspart and insulin glulisine. Short-acting insulin, eg Actrapid: soluble insulin starts working within 30 to 60 minutes and lasts six to eight hours. Continue reading >>

About Fast-acting Mealtime Insulin

About Fast-acting Mealtime Insulin

What is mealtime insulin? Mealtime insulins are fast-acting insulins that are taken immediately before or after meals. As you eat, your blood sugar naturally goes up, or “spikes.” Humalog® (a fast-acting insulin) works to manage those blood sugar spikes and may help keep your sugar levels in balance. Humalog should be taken within 15 minutes before eating or right after eating a meal. People who take Humalog will usually continue to take longer-acting insulin to help manage blood sugar levels at night and between meals. Taking mealtime insulin in addition to longer-acting insulin may help to control blood sugar levels throughout the day. Low blood sugar (hypoglycemia) is the most common side effect of Humalog that may be severe and cause unconsciousness (passing out), seizures, and death. Test your blood sugar levels as your doctor instructs. Talk to your doctor about low blood sugar symptoms and treatment. The orange area shows how blood sugar levels typically rise after meals. The pattern of insulin action may vary in different individuals or within the same individual. Comparing types of insulin Take a look at our overview below to find out about the different types of insulin. You’ll notice that there are differences in when the types of insulin reach your bloodstream, when they “peak” in your body, and how long they can last (length of time the insulin keeps lowering your blood sugar). Fast-acting insulin (also called rapid-acting) is absorbed quickly and starts working in about 15 minutes to lower blood sugar after meals. Humalog fast-acting insulin should be taken 15 minutes before eating or right after eating a meal. Depending on the type of diabetes you have, you may need to take Humalog with a longer-acting insulin or oral anti-diabetes medication. Continue reading >>

Insulin: The Holy Grail Of Diabetes Treatment

Insulin: The Holy Grail Of Diabetes Treatment

Insulin is a hormone made by beta cells in the pancreas. When we eat, insulin is released into the blood stream where it helps to move glucose from the food we have eaten into cells to be used as energy. In people with type 1 diabetes, the body produces little or no insulin as the cells that produce insulin have been destroyed by an autoimmune reaction in the body. Insulin replacement by daily injections is required. In people with type 2 diabetes the body produces insulin but the insulin does not work as well as it should. This is often referred to as insulin resistance. To compensate the body makes more but eventually cannot make enough to keep the balance right. Lifestyle changes can delay the need for tablets and/or insulin to stabilise blood glucose levels. When insulin is required, it is important to understand that this is just the natural progression of the condition. RMIT University have produced a short overview of insulin, a drug that keeps in excess of one million Australians alive. Watch the video to understand why insulin is important and why so many Australians rely on it to stay alive. Copyright © 2015 RMIT University, Prepared by the School of Applied Sciences (Discipline of Chemistry). At this stage, insulin can only be injected. Insulin cannot be given in tablet form as it would be destroyed in the stomach, meaning it would not be available to convert glucose into energy. Insulin is injected through the skin into the fatty tissue known as the subcutaneous layer. You do not inject it into muscle or directly into the blood. Absorption of insulin varies depending on the part of the body into which you inject. The tummy (abdomen) absorbs insulin the fastest and is the site used by most people. The buttocks and thighs are also used by some people. While i Continue reading >>

Insulin For Type 2 Diabetes: When, Why, And How

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 >>

Can You Have Low Blood Sugar With Type 2 Diabetes?

Can You Have Low Blood Sugar With Type 2 Diabetes?

back to Overview Know-how Type 2 A tag-team approach on low blood sugar with type 2 diabetes. Markus recently wrote an article on our German language blog talking about low blood sugar with type 2 diabetes. The question (“can I have low blood sugar with type 2 diabetes?”) is very common, and it’s easy to see why it’s of concern. So I’ve helped Markus bring his German post to life here in English. I hope it helps! Here’s Markus: Low blood sugar In 2014, results from the DAWN2 study were announced. It was the largest study of its kind (15,000 participants) on the “fears & needs of people with diabetes and their families.” One result stood out: The gravest fears are related to low blood sugars, especially at night. Up to 69% of the participants share this fear! So! Can you have low blood sugar with type 2 diabetes? Yes! Of course! But let’s think about who exactly is at risk – and why. It’s common to think: Type 1 diabetes = at risk for lows Type 2 diabetes = not at risk for lows But that isn’t correct at all, so we should wipe it from our mind. So… what do I need to know? Maybe it’s more accurate to say that people with type 2 diabetes who take certain types of medication are more at risk for lows. We’re getting closer! But to get to the truth, we should take a look at someone without diabetes. Is it possible for them to have lows, too? Theoretically yes, especially if doing long-lasting physical activities without proper food intake. Additionally, extreme stress and binge drinking are also common causes of low blood sugar for people without diabetes. However, it’s pretty rare because as soon as BG’s drop below 80 mg/dl (4.4 mmol/L), the natural counterregulatory system kicks in, raising blood sugar back to normal levels. I’ve never exp Continue reading >>

Insulin Treatment

Insulin Treatment

Insulin is a hormone made in your pancreas, which lies just behind your stomach. It helps our bodies use glucose for energy. Everyone with Type 1 diabetes and some people with Type 2 diabetes need to take insulin – either by injection or a pump – to control their blood glucose levels (also called blood sugar levels). Injecting insulin Insulin is injected using a syringe and needle, or an insulin pen or needle. The needles used are very small as the insulin only needs to be injected under the skin (subcutaneously) – not into a muscle or vein. Once it's been injected, it soaks into small blood vessels and is taken into the bloodstream. As your confidence grows and you become more relaxed, injections will get easier and soon become second nature. The most frequently used injection sites are the thighs, buttocks and abdomen. You may be able to inject into your upper arms, but check with your diabetes team first as this isn't always suitable. As all these areas cover a wide skin area, you should inject at different sites within each of them. It is important to rotate injection sites, as injecting into the same place can cause a build up of lumps under the skin (also known as lipohypertrophy), which make it harder for your body to absorb and use the insulin properly. The three groups of insulin There are three groups of insulin – animal, human (not from humans but produced synthetically to match human insulin) and analogues (the insulin molecule is like a string of beads; scientists have managed to alter the position of some of these beads to create 'analogues' of insulin). Nowadays, most people use human insulin and insulin analogues, although a small number of people still use animal insulin because they have some evidence that they otherwise lose their awareness of Continue reading >>

Controlling Blood Sugar In Diabetes: How Low Should You Go?

Controlling Blood Sugar In Diabetes: How Low Should You Go?

Diabetes is an ancient disease, but the first effective drug therapy was not available until 1922, when insulin revolutionized the management of the disorder. Insulin is administered by injection, but treatment took another great leap forward in 1956, when the first oral diabetic drug was introduced. Since then, dozens of new medications have been developed, but scientists are still learning how best to use them. And new studies are prompting doctors to re-examine a fundamental therapeutic question: what level of blood sugar is best? Normal metabolism To understand diabetes, you should first understand how your body handles glucose, the sugar that fuels your metabolism. After you eat, your digestive tract breaks down carbohydrates into simple sugars that are small enough to be absorbed into your bloodstream. Glucose is far and away the most important of these sugars, and it's an indispensable source of energy for your body's cells. But to provide that energy, it must travel from your blood into your cells. Insulin is the hormone that unlocks the door to your cells. When your blood glucose levels rise after a meal, the beta cells of your pancreas spring into action, pouring insulin into your blood. If you produce enough insulin and your cells respond normally, your blood sugar level drops as glucose enters the cells, where it is burned for energy or stored for future use in your liver as glycogen. Insulin also helps your body turn amino acids into proteins and fatty acids into body fat. The net effect is to allow your body to turn food into energy and to store excess energy to keep your engine running if fuel becomes scarce in the future. A diabetes primer Diabetes is a single name for a group of disorders. All forms of the disease develop when the pancreas is unable to Continue reading >>

Diabetes: How To Use Insulin

Diabetes: How To Use Insulin

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website. What is insulin, and why do I need it? Insulin is a hormone that controls the level of blood sugar (also called glucose) in your body. People with diabetes may not have enough insulin or may not be able to use it properly. The sugar builds up in the blood and overflows into the urine, passing out of your body unused. Over time, high blood sugar levels can cause serious health problems. All people with type 1 diabetes, and some people with type 2 diabetes, need to take insulin to help control their blood sugar levels. (The box below lists the different types of insulin.) The goal in treating diabetes is to keep the blood sugar level within a normal range. Do I need to monitor my blood sugar level? Yes. You need to check your blood sugar level regularly using a blood glucose monitor. Your doctor or the office staff can teach you how to use the monitor. You'll need to write down each measurement and show this record to your doctor, so your doctor can tell you how much insulin to take. How often will I need to take insulin? Your doctor will give you a schedule. Most people with diabetes need at least 2 insulin shots a day. Some people need 3 or 4 shots for good blood sugar control. When should I take insulin? If you take Regular insulin or a longer-acting insulin, you should generally take it 15 to 30 minutes before a meal. If you take insulin lispro (brand name: Humalog), which works very quickly, you should generally take it less than 15 minutes before you eat. What is different Continue reading >>

Insulin Injection

Insulin Injection

Insulin injection is used to control blood sugar in people who have type 1 diabetes (condition in which the body does not make insulin and therefore cannot control the amount of sugar in the blood) or in people who have type 2 diabetes (condition in which the blood sugar is too high because the body does not produce or use insulin normally) that cannot be controlled with oral medications alone. Insulin injection is in a class of medications called hormones. Insulin injection is used to take the place of insulin that is normally produced by the body. It works by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. All of the types of insulin that are available work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Insulin comes as a solution (liquid) and a suspension (liquid with particles that will settle on standing) to be injected subcutaneousl Continue reading >>

> Diabetes: What's True And False?

> Diabetes: What's True And False?

If you're like most people with diabetes, you'll get all kinds of advice about it from friends and family or online. Some of this information is wrong. Here's the truth about some of the common things you might hear. No, it doesn't. Type 1 diabetes happens when cells in the pancreas that make insulin are destroyed. This happens because something goes wrong with the body's immune system. It has nothing to do with how much sugar a person eats. Sugar doesn't cause diabetes. But there is one way that sugar can influence whether a person gets type 2 diabetes. Consuming too much sugar (or sugary foods and drinks) can make people put on weight. Gaining weight leads to type 2 diabetes in some people. Of course, eating too much sugar isn't the only reason why people gain weight. Weight gain from eating too much of any food can make a person's chance of getting diabetes greater. Can people with diabetes eat sweets? Yes! You can have your cake and eat it too, just not the whole cake! Like everyone, people with diabetes should put the brakes on eating too many sweets. But you can still enjoy sweets sometimes. Do people "grow out of" diabetes? People with type 1 diabetes don't grow out of it. With type 1 diabetes, the pancreas stops making insulin and won't make it again. People with type 1 diabetes will always need to take insulin, at least until scientists find a cure for diabetes. People with type 2 diabetes will always have a tendency to get high blood sugar levels. But if they take steps to live a healthier life, it can sometimes lower their blood sugar. If people eat healthy foods and exercise enough to get their blood sugar levels back on track, doctors might say they can stop taking insulin or other medicines. Can you catch diabetes from a person who has it? No. Diabetes is Continue reading >>

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