Insulin therapy is often a crucial part of diabetes treatment. Understand the key role that insulin plays in managing your blood sugar levels and preventing diabetes complications.
What Is Insulin? The Role of Insulin in the Body
Insulin is a hormone produced by the pancreas that allows your body to use glucose (sugar) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keep your blood sugar levels from getting too high (hyperglycemia) or too low (hypoglycemia).
If you don’t have diabetes, insulin can help:
- Regulate blood sugar levels. After you eat, carbohydrates are broken down into glucose – a sugar that is the body’s main source of energy. Then, glucose enters the bloodstream. The pancreas responds by producing insulin, allowing glucose to enter the body’s cells to provide energy.
- Store extra glucose for energy. After you eat (when insulin levels are high) extra glucose is deposited in the liver in the form of glycogen. Between meals (when insulin levels are low), the liver releases glycogen into the bloodstream in the form of glucose – this keeps blood sugar levels within a narrow range.
If you have diabetes:
Your blood sugar levels will continue to rise after you eat because there isn’t enough insulin to move the glucose into your body’s cells. People with type 1 diabetes make little or no insulin. Meanwhile, people with type 2 diabetes don’t produce enough insulin (insulin deficiency) or don’t use insulin efficiently (insulin resistance).
Untreated, high blood sugar levels can eventually lead to complications, such as kidney damage and never damage.
Insulin as Diabetes Treatment: Goals of Insulin Therapy
Insulin injections can help treat both types of diabetes – the injected insulin acts as a replacement for or as supplement to your body’s insulin.
If you have type 1 diabetes, insulin injections are vital for replacing the insulin your body doesn’t produce.
If you have type 2 diabetes, you can manage your blood glucose levels with lifestyle changes and medication. However, if these treatments don’t help control your blood glucose levels, you may also need insulin injections to keep your blood sugar levels within the desired range.
Insulin therapy can help prevent diabetes complications by keeping your blood sugar levels within your target range.
Possible Side Effects
Insulin injections may cause certain side effects. Talk to your doctor if any of these symptoms are severe or if they don’t go away.
- Swelling, itching, and redness at the injection site
- Weight gain
- Changes in the feel of your skin, a little depression in the skin (fat breakdown), or skin thickening (fat build-up)
Some side effects can be serious and life-threatening. If you experience any of the following symptoms, contact your doctor immediately.
- Blurred vision
- Shortness of breath
- Rash and/or itching over the whole body
- Abnormal heartbeat
- Difficulty breathing or swallowing
- Muscle cramps
- Large weight gain in a short period of time
- Swelling of the arms, hands, feet, ankles, or lower legs
Types of Insulin Treatments
All types of insulin treatments produce the same effect – they mimic the natural decreases and increases of insulin levels in the body. However, they differ in how quickly and how long they can control blood sugar.
The different types of insulin treatments include:
- Rapid-Acting Insulin. Rapid-actin insulin starts working about 15 minutes after injection. Its effects can last between 3 and 4 hours. It is often injected before meals.
- Short-Acting Insulin. Short-acting insulin starts working in 30 to 60 minutes after injection. Its effects may last up to 5 to 8 hours. This type of insulin is injected before meals.
- Intermediate-Acting Insulin. Intermediate-acting insulin starts working around 1 to 2 hours after injection. Its effects may last up to 14 to 16 hours.
- Long-Acting Insulin. Long-acting insulin may not start working until around 2 hours after you inject it. Its effects can last up to 24 hours or longer.
Insulin Delivery Options
You can’t take insulin by mouth, because the digestive system would break it down before it even has a chance to work. You must inject it with an insulin pen, syringe, or insulin pump. Your doctor can help you decide which fits best with your treatment and lifestyle needs.
Insulin delivery options include:
- Insulin Pens or Shots. Using a syringe and needle or a pen-like device that hold insulin with a needle attached, insulin can be injected into the fat just below your skin. How often you inject it depends on the type of diabetes you have, how often you eat, and your blood sugar levels. You may have to inject it multiple times each day.
- Insulin Pump. An insulin pump pushes small, steady doses of rapid-acting insulin into a thin tube which is inserted beneath your skin. These doses are repeatedly delivered throughout the day. There are different kinds of insulin pumps available, so choose one that best suits your needs.
- Inhaled Insulin. Inhaled insulin (Afrezza) is rapid-acting and you inhale it at the beginning of every meal. People who smoke or have lung issues like asthma shouldn’t use inhaled insulin.
Where to Inject Insulin
Insulin is injected subcutaneously. In this type of injection, a short needle is used to inject insulin directly into the fatty layer between the skin and muscle.
Note that insulin must be injected into the fatty tissue just below your skin. If you inject the insulin deeper into the muscle, your body will end up absorbing it too quickly, its effects might not last as long, and the injection is typically more painful. This can lead to low blood sugar levels.
But, where should you inject insulin? Here are some common insulin injection sites.
- Abdomen. The abdomen is the preferred site for insulin injections. Insulin is absorbed more predictably and quickly there, and this part of your body is also easy to reach. Choose an injection site between the bottom of your ribs and pubic area – steer clear of the 2-inch area around your navel.
You’ll also want to avoid areas around moles, scars, and skin blemishes – these can hinder with the way your body absorbs insulin. Stay clear of varicose veins and broken blood vessels, too.
- Arm. Inject insulin into the fatty area on the back of your arm – between your shoulder and elbow.
- Thigh. You can inject insulin into the outer and top areas of your though, around 4 inches down from the top of your leg and 4 inches up from your knee.
How to Inject Insulin
Before injecting insulin, double-check its quality. If it was refrigerated, let the insulin come down to room temperature. If the insulin is cloudy, mix the contents by rolling the vial between your hands for a couple of seconds – be careful not to shake the vial. Short-acting insulin that isn’t mixed with other insulin must not be cloudy.
Do not use insulin that’s thickened, discolored, or grainy.
Here’s a step-by-step guide for proper and safe insulin injection.
- Gather all the necessary supplies, this includes the medication vial, needles and syringes, gauze, alcohol pads, bandages, and puncture-resistant sharps containers (for proper syringe and needle disposal).
Bonus Tip: Wash your hands thoroughly with warm water and soap for at least 20 seconds. Be sure to wash the backs of your hands, under your fingernails, and between your fingers.
- Hold the syringe upright and pull the plunger down until the tip of the plunger reaches the measurement equal to the dose that you plan to inject.
- Remove the caps from the needle and insulin vial. If you’ve used the vial before, make sure to wipe the stopper on top with an alcohol swab.
- Slowly push the needle unto the stopper. Then, push the plunger down so that the air in the syringe goes into the bottle – the air replaces the amount of insulin you’ll withdraw.
- Turn the vial upside down while keeping the needle in the vial. Then, pull the plunger down until the top of the black plunger reaches the accurate dosage on the syringe.
- If you notice any bubbles in the syringe, gently tap it so the bubbles rise to the top. Then, push the syringe to release the bubbles back into the vial. Pull the plunger down again until you reach the appropriate dose.
- Carefully set the insulin vial down. Then, hold the syringe as you would a dart – with your finger off of the plunger.
- With an alcohol pad, thoroughly swab the injection site. Let it dry for a few minutes before you insert the needle.
- To avoid injecting into the muscle, pinch a 1- to 2-inch portion of your skin gently. Then, insert the needle at a 90-degree angle, push the plunger all the way down, and wait for about 10 seconds. Note: If you’re using a smaller needle, the pinching process may not be necessary.
- Immediately release the pinched skin after you have pushed the plunger down. Remove the needle. Don’t rub the injection site. Also, you may notice minor bleeding after the injection – apply light pressure to the area with gauze and cover with a bandage if needed.
Insulin therapy is often a crucial part of diabetes treatment.
Use appropriately, insulin injections can help keep your blood sugar levels within a healthy range. Healthy blood sugar levels help reduce the risk of diabetes complications, such as nerve damage, blindness, and kidney damage.
Disclaimer: The information on this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. All information contained on this web site is for general information purposes only.