MANAGING DIABETES

Understanding insulin

Your guide to different kinds of insulin treatments

Many people can manage their type 2 diabetes through a combination of lifestyle changes—such as healthy eating and moderate to vigorous aerobic activity—and medication(s). If one combination of lifestyle changes and medication isn't enough, then you can work with your doctor and find out which additional medications you should add to your diabetes care plan; this is called "treatment intensification." And since your diabetes can change over time, your doctor will let you know if your medicine also has to change.

Insulin is one type of diabetes medication that is taken to help keep blood glucose within target range.

There are many factors that determine when your doctor may choose to introduce insulin into your care plan. Depending on your blood glucose levels or your specific situation, your doctor may decide to begin insulin therapy earlier on. Other times, insulin can get added later on in your diabetes treatment journey as a treatment intensification.

No matter when insulin gets added to your care plan, it’s important to remember that this does not mean failure. Think of it as giving your body the extra support and tools it needs to help stay on track.

There are different types of insulin and most are taken through an injection.

Insulin Medicines

InsulinInsulinA hormone made by the beta cells in the pancreas that helps glucose move from the blood into the cells. Insulin is also an injectable medicine that is used to treat diabetes by controlling the level of glucose in the blood. is a hormone that your body makes naturally and is important for producing energy from food. Some people with type 2 diabetes may not be able to use their own insulin well. This is called insulin resistance, and it causes blood glucose levels to increase. 

As diabetes changes over time, the body makes less insulin, making it difficult to control blood glucose levels. This is where insulin may come in. It can be injected to help lower blood glucose levels back to their normal range.

Different insulin medicines work in different ways to replace the insulin you’re missing. They are grouped together based on:

  • When they start to work (onset)
  • When they have the greatest effect on blood glucose (peak)
  • How long they work (duration)

Ways to describe insulin medicine

Human insulin

Human insulin is actually made in a lab. It’s called “human” because the structure is identical to the insulin your body makes.

There are 3 types of human insulin:

  1. Short-acting. This insulin, also called regular insulin, is usually taken 30 minutes before a meal and lasts 3 to 6 hours.
  2. Intermediate-acting. This type of human insulin, also called NPH insulin, is taken 30 minutes before breakfast, before the evening meal, or at bedtime, and is effective for anywhere from 12 to 18 hours.
  3. Premixed. This type of human insulin includes both a regular insulin and an intermediate-acting insulin. It is taken 30 minutes before breakfast and/or the evening meal and works for anywhere from 10 to 18 hours.

Insulin analogs

Insulin analogs are human insulin with small changes made to the hormone so that it is absorbed faster or lasts longer in the body.

The 3 main types of insulin analogs are:

  1. Long-acting. Also called basal insulinBasal insulinA type of injected insulin that is absorbed slowly and starts to lower blood glucose within 4 to 6 hours after injection. Its strongest effect is 10 to 18 hours after injection depending on the product. This gives the body a low level of insulin to manage blood glucose between meals and overnight., this type is not taken with food. It works slowly and lasts longer to control blood glucose between meals and when you sleep. 
  2. Fast-acting. Also called bolusBolusBolus insulin (prandial or mealtime insulin) is insulin taken to cover an expected rise in blood glucose resulting from a meal or snack. It can also be taken when blood glucose is high. insulin. Depending on the medicine, this type of insulin may be taken just before a meal, at meal time, or shortly after starting a meal. 
  3. Premixed. This type is a mixture of fast-acting and intermediate-acting insulins. It works to control blood glucose at meal time and works for anywhere from 16 to 24 hours

While each type of insulin helps manage blood glucose, no particular type is right for everyone. Each person’s insulin need is different and may change over time. Your doctor will prescribe the insulin that is best for you.

Test your knowledge

You are encouraged to check your blood sugar levels before injecting insulin, even if you're on a schedule.

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Factors such as food, physical activity, and even exciting events can all affect your blood sugar. Checking your insulin level before injecting allows you to make decisions about your insulin dose.

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