Type 2 diabetes: treatment with insulin

0


What is it about ?

Diabetes is a chronic disease of the metabolism characterized by a high level of sugar (blood sugar) in the blood, called hyperglycemia. Insulin is the hormone that regulates blood sugar levels, it causes cells to take in enough sugar (glucose) from the blood.

In type 2 diabetes, the body still produces insulin, but too little. In addition, cells are less sensitive to the effects of insulin. Suddenly, there is too much sugar in the blood.

a healthy lifestyle and treatment with one or more drugs, taken by mouth or by injection, allow effective management, sometimes for life, of the majority of people with type 2 diabetes. In others, the diabetes gets worse gradually and these drugs are no longer sufficient. Insulin injections then become necessary. Sometimes, when the blood sugar (blood sugar) level drops enough, it is possible to switch back from insulin to medication.

When you have to have an operation or are seriously ill (such as a severe infection or a heart attack), your body needs more insulin. It is therefore sometimes necessary in these situations to temporarily add insulin to your treatment.

Insulin

There are different types of insulin, which are classified according to their duration of action.

  • Short-acting insulin starts working in 5 to 15 minutes, peaks after 1 hour, and continues to work for 2 to 5 hours.
  • Long-acting insulin peaks after about 2 hours and can work for up to 24 hours.
  • There are also mixtures, which combine a fast effect and a slow, prolonged effect. They start to work after 20 to 30 minutes and continue to work for 10 to 16 hours.
  • Medicines that decrease insulin resistance, such as metformin
  • The initial drugs in the management of diabetes, which do not decrease all insulin resistance and which are not all taken by mouth.

And in practice, how does it work?

Most of the time, you start with 1 injection of long-acting insulin after your evening meal. The injected insulin does the same job as the natural insulin produced by your pancreas.

The number of units of insulin needed varies from person to person (8 to 200 units). Most often, you will start with an injection of 10 units of insulin in the evening. Then you can optionally increase the dose on your own, but always in consultation with your doctor, for example every third day.

Eating healthy and at set times is very important.

You will usually need to keep taking any medications you were already taking before you started insulin. A single injection of long-acting insulin given at night is not always enough to achieve good blood sugar control. In this case, it is possible to adopt a schedule of several insulin injections per day. For example, injections consisting of a mixture of short- and long-acting insulin are used. The first injection is administered before breakfast and the second, before the evening meal.

Insulin administration

Insulin is given by injections under the skin (subcutaneous injections), using an insulin pen or an insulin pump. It is very important to use this material correctly.

The length of the needle varies depending on the person’s weight and the amount of subcutaneous fat. The best injection site is the belly (although other sites are also possible). It is recommended to vary the injection site on the same site to avoid damaging the skin over time.

The injection pen needles are preferably used once. When multiple injections per day are scheduled, it is possible to reuse the same pen needle for up to 24 hours as long as it is not visibly blunt, dirty and / or deformed. Never use someone else’s pen.

The skin must be intact. Injections should therefore not be given to a scratch, scar or eczema lesion.
The injection site should also be dry. It is not necessary to disinfect the skin or the refill.

In practice

  • Mix the insulin well by gently inverting the pen 10 to 20 times.
  • “Prime” the syringe before injecting the insulin. To do this, set 2 units of insulin and press the injection button on the pen until a droplet appears at the tip of the needle. This step also ensures that the needle is not blocked.
  • Now set the dose to be given and give the injection.
  • Do not withdraw the needle yet, but wait 10 seconds.
  • Do not massage the skin after the injection.

Conservation

  • Before opening the package, insulin can be stored in a cool place (2 to 8 ° C) until the expiry date.
  • Once the cartridge is put into an insulin pen, it can still be used for 4 weeks.
  • To avoid temperature differences, it is not recommended to put insulin back in the fridge after each use.
  • No insulin preparation can be frozen. So do not keep your insulin in the freezer of your fridge.
  • If you are flying, take insulin in your carry-on baggage. Indeed, it often freezes in the hold of an airplane.
  • Insulin should also not be exposed to high temperatures. It begins to lose its effectiveness above 30 ° C. Protect the packaging from the sun or use a special cooler bag if necessary.

How to adjust your insulin dose?

Since the dose of insulin your body needs may vary, your doctor or nurse will teach you how to adjust your insulin dose. To do this, you will base yourself among other things on the blood sugar measured on a drop of blood taken at the tip of your finger. You may also need to adjust your insulin dose according to your schedule for the day.

Achieving satisfactory blood sugar control can take time… be persistent!

Find out more

Are you looking for more specialized help?

Sources

www.ebpnet.be
www.diabete.be