subject: Insulin Therapy [print this page] The hormone insulin is made by beta cells inside the pancreas. In type 1 diabetes, the pancreas does not make any insulin at all while in type 2 diabetes the pancreas still makes insulin but the body does not respond well to it. Insulin therapy is absolutely necessary in type 1 diabetes as insulin is needed to convert glucose into energy. Some people with type 2 diabetes may also need insulin shots along with diabetes pills to help their bodies utilize glucose for energy. Insulin must be injected to bring it quickly into the blood. It cannot be taken orally as it is broken down during digestion similar to protein in food.
The most common way of delivering insulin into the blood is by the use of insulin syringes. Other ways of insulin delivery is by using insulin pens and insulin pumps. Insulin is injected in the same area of the body for consistency usually in the stomach, thigh or arm areas. This does not mean that it should be injected in exactly the same spot but injection site must be rotated around generally similar area. This makes insulin enter the blood stream at approximately the same time during each injection.
People with type1 diabetes normally begins with one to two injections daily of two different types of insulin. This usually progresses to three to four injections daily of different types of insulin. The type of insulin used depends on blood glucose level. Those with type2 diabetes may require a single injection daily without taking diabetes pills. Some may require the injection at bedtime along with diabetes pills. When diabetes pills are well-tolerated and stops working, the injections may progress in the same rate as type1 diabetes.
Self-monitoring of blood glucose is important for somebody on insulin therapy. A regular and consistent recording helps a person know the effect of diet, exercise, injection site, time of injection, illness and stress on blood glucose levels. This guides a person's decision about food, activity and dosage.
Insulin shots must be timed to coincide with the entry into the blood of glucose from the food. Depending on the type of insulin prescribed - whether it's rapid-acting, intermediate-acting or regular-acting - this can vary from a few to 30 minutes prior to eating. When using insulin pumps, a bolus dose can be programmed to coincide with each meal times.
A diabetic should also be aware of natural high in blood glucose level occurring during mornings, an occurrence known as "Dawn Phenomenon". This is usually caused by hormone released at the start of sleep or may be due to minimal insulin dosage the night before.
