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Treating Diabetes With Insulin

Source: The Cleveland Clinic
Insulin is a hormone that controls blood glucose. It is injected instead of taken in pill form because when insulin is taken by mouth the acids in your stomach destroy most of it. Injecting insulin under the skin bypasses your stomach and allows it to stay in your body for different lengths of time, depending on the type of insulin used.

What Are the Different Types of Insulin?

There are many forms of insulin. They are classified by how fast they start to work and how long their effects last.

The types of insulin include:

· Very rapid acting
· Rapid-acting
· Intermediate-acting
· Long-acting
· Pre-mixed

Your doctor will prescribe the insulin that is best for you.

Where Does Insulin Come From?

Almost all of the insulin made and sold in the U. S. is made in a lab. The genetic information for making human insulin is put into bacteria or yeast cells, and the insulin made is purified and sold as human insulin. A small percentage of insulin comes from the pancreas of pigs, but as the supply decreases, this will be phased out.

How Is Insulin Injected?

Insulin comes in different forms. It can be injected using a syringe, cartridge or prefilled pen systems, and in a recently developed needleless injection system.

Insulin Pumps

Insulin pumps are small, computerized devices (about the size of a pager) that you wear on your belt or put in your pocket. They have a small flexible tube (called a catheter) with a fine needle on the end. The needle is inserted under the skin of your abdomen and taped in place. A carefully measured, steady flow of a rapid-acting insulin is released into the tissue.  

The insulin pump is designed to deliver a continuous amonth of insulin, 24 hours a day according to a programmed plan unique to each pump wearer. A small amount of insulin is given continually, this is called the basal rate. This is the amount of insulin needed to keep the blood sugar in the target range between meals and overnight.

A bolus dose of insulin can be programmed into the pump when food is eaten. You can measure how much of a bolus you need using calculations based on the amount of and type of food that is being consumed

When using an insulin pump, you must monitor your blood glucose level at least four times a day. You set the doses of your insulin and make adjustments to the dose depending on your food intake and exercise program. The pump frees you from having to measure insulin into a syringe.

Some healthcare providers prefer the insulin pump because its slow release of insulin mimics how a normally working pancreas would release insulin. Studies vary on whether the pump provides better blood glucose control than multiple daily injections.

Jet-spray Injectors

Jet-spray injectors are designed to give insulin without the use of a needle. They use pressure to force a jet stream of insulin under the skin.

Talk to your healthcare provider to find out which insulin delivery system is right for you.

Where On the Body Should Insulin Be Injected?

The place on the body where you inject your insulin may affect the timing of its benefit to you. The abdomen (stomach) has the fastest rate of absorption, followed by the arms, thighs, and buttocks.

What Do I Need to Know When I Pick Up My Insulin Prescription?

Before you pay for your insulin at the pharmacy, always check the label to make sure it’s the type prescribed by your doctor. (Using the wrong type can affect your blood glucose control.) Then check the expiration date on the insulin box. The date must allow you enough time to use the whole bottle. To find out how long the medicine will last, divide the number of units in the bottle by the number of units you take each day.

How Should I Store My Insulin?

Always keep two bottles of each type of your insulin on hand. The bottle that you are using may be stored at room temperature (not higher than 80 degrees F) for 30 days. Store it where it will not get too hot or too cold and keep it out of direct sun. A good rule of thumb is that if the temperature is comfortable for you, the insulin is safe.

The extra bottle of insulin (and other extra bottles of insulin) should be stored in the refrigerator (do not allow your insulin to freeze). The night before you are ready to use your new bottle of insulin, take it out of the refrigerator and allow it to warm to room temperature.

For insulin pens, check the package insert for storage instructions.

If you are carrying your insulin with you, be careful not to shake it. Shaking the bottle creates air bubbles that can affect the amount of insulin you withdraw for an injection.

When Do I Take My Insulin?

Follow your healthcare provider’s guidelines on when to take your insulin. The time span between your insulin injection and meals may vary depending on the type of insulin you are taking.

If you use Humalog insulin, you should generally take it 10 minutes before eating a meal or take it with your meal.

If you use regular- or intermediate-acting insulin, you should generally take it about one half-hour before your meals or at bedtime. By taking your insulin one half-hour before meals, you are allowing your food to be absorbed at the same time that the insulin starts to work. This will help you avoid low blood glucose reactions.