Insulin

Managing type 1 Diabetes imageInsulin is a hormone made by beta cells in the pancreas. When we eat, insulin is released into the blood stream where it helps to move glucose from the food we have eaten into cells to be used as energy. In people with diabetes the body produces little or no insulin.

For Type 1 - In people with type 1 diabetes, the body produces little or no insulin as the cells that produce insulin have been destroyed by an autoimmune reaction in the body. Insulin replacement is required by daily injections.

For Type 2 - In people with type 2 diabetes the body produces insulin but the insulin does not work as well as it should. This is often referred to as insulin resistance.  To compensate the body makes more but eventually cannot make enough to keep the balance right. Lifestyle changes can delay the need for tablets and/or insulin to stabilise blood glucose levels. When insulin is required, it is important to understand that this is just the natural progression of the disease.

At this stage, insulin can only be injected.

Insulin cannot be given in tablet form as it would be destroyed in the stomach. This means that the insulin would not be available to convert glucose into energy.

In this Topic

Starting Insulin
Types of Insulin
Administering Insulin
Insulin Syringes
Insulin Delivery Devices
Insulin Pump
Where to Inject Insulin
FAQs

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Starting Insulin

The range of injection devices and tiny needles available today make injecting insulin much easier than most people imagine. When starting insulin, your doctor and Credentialled Diabetes Educator will help you adjust to the new routine and task of giving insulin and find the right dose to reduce your blood glucose levels to acceptable levels.

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Types of Insulin

When you take insulin it acts to reduce the level of glucose in your blood. When glucose is at its lowest level, the effect of the insulin is said to have reached its 'peak'. After this, the effect gradually wears off and blood glucose levels rise. The time it takes for insulin to 'peak' and wear off differs according to the type of insulin it is.

People's need for insulin varies according to their body's reaction to insulin (which differs from person to person) as well as their lifestyle, including their exercise and eating patterns.

Your doctor or Credentialled Diabetes Educator will work out with you what type of insulin is right for you.

Fast Acting Insulin

Fast acting insulins are clear in appearance. These insulins:

  • Are very fast acting starting to work from 1 to 20 minutes
  • Peak approximately one hour later
  • Last from 3 to 5 hours.

You must eat immediately after injecting one these insulins.

Short Acting Insulin

Short acting insulins are clear in appearance. These insulins:

  • Begin to lower blood glucose levels within half an hour so you need to have your injection half an hour before eating
  • Peak effect at 2 to 4 hours
  • Last for 6 to 8 hours.
Intermediate Acting Insulin

Intermediate acting insulins are cloudy in appearance. They have either protamine or zinc added to delay their action. These insulins:

  • Begin to work about 1 1/2 hours after injecting
  • Peak at 4 to 12 hours
  • Last for 16 to 24 hours.

Before injecting this type of insulin, check the leaflet inside the pack for instructions on how to prepare the insulin.

Mixed Insulin

Mixed insulins are cloudy in appearance. They contain pre-mixed combinations of either a fast acting or a short acting insulin and intermediate acting insulin, making it easier by giving two types of insulin in one injection. If the insulin is ‘30/70’ then it contains 30% fast acting and 70% intermediate acting insulin. ‘50/50’ is 50% of each. This insulin can be taken before a meal to meet the increase in blood glucose levels and provide a stable level of insulin for some hours after the meal.

Before injecting this type of insulin, check the leaflet inside the pack for instructions on how to prepare the insulin.

Long Acting Insulin Long acting insulins are clear in appearance. They typically have no pronounced peak and last for up to 24 hours.

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Administering Insulin

Insulin can be injected by an insulin syringe, an insulin pen with a fine needle, or via an insulin pump. Each method is chosen for a particular purpose and based on an individual’s needs.

Your doctor or Credentialled Diabetes Educator can teach you the correct injection and dose measurement techniques.

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Insulin Syringes

Insulin syringes are currently the most common way of administering insulin.

Syringes are manufactured with different measurements. The different sizes are used depending on the quantity of insulin being injected. To avoid under or over dosing, it is important that you know how to measure the insulin does in your chosen syringe.  Your Credentialled Diabetes Educator can help you with this.

Syringes are free for people registered with the National Diabetes Services Scheme (NDSS). Syringes should only be used once, and then disposed of in an appropriate syringe disposal unit.

For more information: contact Diabetes Australia on 1300 136 588.

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Insulin Delivery Devices

Insulin Delivery Devices are another common way of administering insulin. They are referred to as ‘pen’ needles because they are shaped like a pen.

Many people find pen devices easier and more convenient to use than syringes. If you have difficulties with your sight or have problems with arthritis you may find a pen device easier to use.

These devices are available in different shapes and sizes. An insulin cartridge (3 ml, containing 300 units of insulin) fits into the device. When finished, a new cartridge is inserted. Some pen devices, however, are pre-filled with insulin and the whole device is disposable. Your doctor or Credentialled Diabetes Educator will advise the one that’s right for your needs and lifestyle.

Pen needles are free for people registered with the National Diabetes Services Scheme (NDSS).

For more information: contact Diabetes Australia on 1300 136 588.

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Insulin Pump

The insulin pump is a small programmable device (about the size of a pager) that holds a reservoir of insulin. The pump is programmed to deliver insulin into the body through thin plastic tubing known as the infusion set or giving set. The pump is worn outside the body, in a pouch or on your belt. The infusion set has a fine needle or flexible cannula that is inserted just below the skin (usually on the abdomen) where it stays in place for two to three days.

Only fast acting insulins are used in the pump. Whenever food is eaten the pump is programmed to deliver a surge of insulin into the body similar to the way the pancreas does in people without diabetes. Between meals a small and steady rate of insulin is delivered.

The insulin pump is not suitable for everyone. If you’re considering using one, you must discuss it first with your doctor of Credentialled Diabetes Educator. The major advantage of an insulin pump is that it reduces the need for insulin injections; however, it requires a regular dose of insulin to be programmed so it is often not suitable for people who do not have predictable blood glucose readings.

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Where to Inject Insulin

Insulin is injected through the skin into the fatty tissue known as the subcutaneous layer where there a fewer nerve cells and so it’s less painful. You do not inject it into muscle or directly into the blood. You should discuss your injection technique with your doctor or Credentialled Diabetes Educator.

Absorption of insulin varies depending on the part of the body into which you inject. The tummy (abdomen) absorbs insulin the fastest and is the site used by most people. The buttocks and thighs are also used by some people.

While it is essential to give each injection in a slightly different spot within the one site (such as the tummy), it is not advisable to change sites without first discussing it with your doctor or Credentialled Diabetes Educator.

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