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Type 2 Diabetes: Insulin Treatment

Type 2 Diabetes: Taking Insulin

The decision to take insulin is never an easy one. For many, it comes after years of having type 2 diabetes and trying multiple weight-loss regimens, diets and medications. For other people, the decision to take insulin is made when blood glucose levels are simply too high to control with other drugs.

The good news is that insulin almost always works: Daily injections, however inconvenient or painful at first, can be very effective at controlling blood glucose. Anxious about giving injections? Help is available. If your doctor prescribes insulin, a trained diabetes educator will teach you how to measure out the proper dose and administer your daily injections.

Why should I use insulin?

Over time, type 2 diabetes can lead to the pancreas being unable to produce insulin on its own. When that happens, your blood glucose levels will become very difficult to control without daily injections of insulin. Injectable insulin is identical to the insulin made by the body. It can be categorized into two main types: Long-acting insulin keeps your blood glucose stable between meals, while short-acting insulin helps your body deal with the quick rise in blood glucose after meals.

You might need insulin if …

  • You have trouble controlling your blood glucose with diet, exercise and other diabetes medications.

  • Your A1c level is higher than 10 percent or your blood glucose level is higher than 300 mg/dL (or higher than 250 mg/dL after not eating for at least eight hours).  

  • You have side effects to other diabetes medications and have poorly controlled blood glucose.

  • You often experience thirstiness, frequent urination or other symptoms of high blood glucose despite taking other medications.

How much insulin will I need?

Most people start with a single bedtime injection of an intermediate-acting insulin, known as NPH, or a long-acting insulin, known as glargine or determir. The same dose of insulin is usually given every night, and a quick blood glucose check in the morning will reveal whether you're taking enough insulin to keep your blood glucose in the healthy range of 80 to 130 mg/dL. Your doctor may need to increase your dose if your A1c level remains high despite normal levels of blood glucose in the mornings. Alert your doctor if your blood glucose drops below 70 mg/dL — this could mean that you are taking more insulin than your body needs.

People with long-standing diabetes sometimes find it necessary to also inject short-acting insulin before meals to help their bodies process the glucoses they consume in foods and drinks.  If your doctor prescribes mealtime insulin as well, you will probably stop taking or cut back on taking oral diabetes medications.

Your doctor or diabetes educator will teach you how to measure your blood glucose before meals and calculate the proper dose of insulin based on the number of carbs you plan to consume.

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