Insulin Facts - What's Important?How Does Too Much Insulin Affect Me? Too much can cause very low blood sugar - a condition called hypoglycemia, that can be quite frightening. It has very striking symptoms 3including clammy pale skin, shaking, shivering, perspiration, rapid heartbeat, hunger, dizziness, anxiety, confusion and blurred vision. In some cases it can cause loss of consciousness (hypoglycemic coma) and seizures. Which Type Should I Use? There are four main kinds available for injection. The type you use will depend on your individual needs and your lifestyle - you should discuss this with your doctor. One way of understanding the different types of this hormone is with a comparison that I first heard from the American Diabetes Association: think of them as different types of athletic runners. "Some types are like sprinters. They start quickly, get to their top speed and finish fast. Other types are more like marathon runners. They start slower and they keep going slow and steady for a long time. And then there are the ones in between - not as fast as a sprint and not as slow as a marathon. No one type is better than another. Different types may be important to keep your diabetes under control." Rapid-acting insulin, also known as lispro or Humalog, is the sprinter. It starts working within 15 minutes after injection and gets up to its top performance at about 1 hour after injection. This eff ct is usually gone in 4 or 5 hours. You can inject this kind right before meals, and it starts to work about the time you start to eat. By the time your meal is digested and sugar is beginning to move into the bloodstream, the rapid-acting hormone is working its hardest to move that sugar from the blood into the cells. Short-acting insulin, or "regular", is also used around mealtime. It starts to take effect later than the rapid-acting type does. So you take the short-acting form about 30 to 45 minutes It is important to eat after taking this hormone, because whether you eat or not, it will lower the sugar levels in the bloodstream. So you can imagine, if you do not eat, you can experience hypoglycemia, just as you would experience it if you took too much insulin for the amount of food you ate. Then there is Intermediate-acting insulin, or NPH and Lente. This variety is mixed with a substance to make the body absorb it more slowly. So this type of insulin looks cloudy and has to be mixed before it's injected. It takes longer to start to work, and it stays in your body for a longer time. NPH usually begins to work about 2 to 4 hours after injection. It peaks 4 to 10 hours after injection, and it keeps working for 10 to 16 hours. Lente lasts even longer than NPH. It peaks at 4 to 12 hours after injection and stays in the body from 12 to 18 hours. Intermediate-acting varieties works all day if taken in the morning. A shot of intermediate-acting hormone in the evening stays in your body all through the night. Since these have such long-lasting effects, intermediate-acting insulin should only be taken when you know you can have regular, predictable meals. Long-acting insulin, also called Ultralente, starts to work in 6 to 10 hours and can stay in the body for 20 hours or more. The long-acting preparation is usually taken in the morning or before bed, like the intermediate-acting types. There is also glargine insulin, which is and very long-acting. It starts to lower blood glucose levels about 1 hour after injection, and keeps working evenly for 24 hours. With these longer-lasting injectable types, discipline is even more important to avoid the problems associated with hypoglycemia. How Often Do I Need to Take Insulin? There are three common insulin regimens. The one that is right for you will be determined by your lifestyle and eating habits. You can work with your doctor or diabetes educator to choose the best regimen.
How is Insulin Taken? Many people use this medication in specially designed disposable pens or in cartridges that work in multiple-use pens.
Needles for the pens are disposable and come in different lengths. Where pens are not available, or too expensive, specially labeled 1 cc syringes are used. Your diabetes specialist will help you decide which is most suitable for you. To prevent infection, a new needle should be used for each injection. This is what it might look like.
A new powdered form of this hormone is available which is inhaled into the lungs using an insulin inhaler, similar to those used for asthma. Pump treatment is sometimes used in young people with diabetes, or people with severe diabetes. The pump utilizes a constant drip-feed of medication through a needle in the skin and extra doses can be injected with meals. The amount of hormonegiven is controlled by a small portable pump called an infusion pump that is worn on the waist. You may see pumps similar to this one.
In my experience, multiple injections give the most flexibility and most closely mirror the body's natural insulin release. But of course you and your doctor will change your dosage and frequency as needed to find the best regimen for you. Do I have to Take an Injection? Unfortunately, the digestive enzymes that break down your food also inactivate insulin, so it cannot be taken by mouth. For this reason, this hormone is usually given as an injection under the skin (the medical term is subcutaneously), most times it is given in the thigh, buttocks, abdomen or upper arm. But the needles used for giving it are very small. And although the injections can be a little painful at first, people soon get used to them. A nurse or someone on your diabetes care team will demonstrate this for you. If you have any concerns or questions about your injection, these are the people to ask for help. Draw up the exact amount of medication you need. To inject, pinch a small fold of skin between your fingers, insert the needle at an angle and inject the right amount of insulin. Slowly pull the needle out and let go of the fold of skin. Use a different injection site for your medication each time, since overusing one site can cause unpredictable absorption of the hormone. This is because of a thickening of the fatty tissue with repetitive injection in the same spot (this thickening is called lipodystrophy). Inhaled insulin The inhaled variety of this hormone is not suitable for everyone with diabetes. People with lung problems, such as asthma and COPD and people who smoke should definitely not use the inhaled form. And since we do not yet know for sure what could be the long-term effects of inhaled insulin on the lungs, it may be best to avoid this type altogether, unless you have very severe problems with the injections. So What can I do to Help Myself?
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