No matter how long you’ve been following a prescribed insulin treatment plan, circumstances beyond your control may ultimately require a change in your insulin.
This can happen for a number of reasons, including hormone changes, aging, disease progression, changes in diet and exercise habits, weight fluctuations, and changes in your metabolism.
While it may seem like a daunting task, the transition is probably easier than you think.
Your A1C Goal
The A1C test, also called a hemoglobin A1c test (HbA1c), is a common blood test used to gauge your average blood sugar level over the past two to three months. Specifically, the test measures the amount of sugar attached to the protein hemoglobin in your red blood cells. This test is used when you’re first diagnosed with diabetes to establish a baseline A1C level. It’s then repeated as you start learning to control your blood sugar.
People without diabetes usually have an A1C level of between 4.5 to 5.6 percent. For diagnosing purposes, A1C levels of 5.7 to 6.4 percent on two separate occasions signify prediabetes. A1C levels of 6.5 percent or higher on two separate tests indicate that you have diabetes. Talk to your healthcare provider about the appropriate A1C level for you. People who have previously-diagnosed diabetes are usually encouraged by their endocrinologist to aim for personalized A1C levels below 7 percent.
How often you need an A1C test depends on a number of factors, including prescribed changes to your insulin treatment and how well you’re keeping your blood sugar level within your target range. During changes in treatment plans and when your A1C values are high, it’s recommended to have an A1C test every three months. When your levels are stable and at the target you’ve set with your doctor, testing every six months is recommended.
Switching from Oral Medication to Insulin
If you have type 2 diabetes, you might be able to treat your condition with lifestyle modifications, such as weight loss, exercise, and oral medications. But there may come a time when switching to insulin might be the only solution to get your blood sugar levels under control.
According to the Mayo Clinic, these are the two common groups of insulin:
Mealtime (or Bolus) Insulin
Rapid-acting insulin is taken with meals and starts working in 15 minutes or less, peaks at 30 minutes to 3 hours, and remains in your bloodstream for up to 5 hours. Short-acting (or regular) insulin is also taken at mealtime and begins working 30 minutes after injection. It peaks in 2 to 5 hours and stays in your bloodstream for up to 12 hours.
This type of insulin is taken once or twice a day (often around bedtime) and keeps your blood sugar levels normal during periods of fasting or sleeping. Intermediate insulin starts to work 90 minutes to 4 hours after injection, peaks in 4 to 12 hours, and works for up to 24 hours after injection. Long-acting insulin begins working within 45 minutes to 4 hours. It doesn’t peak and stays in your bloodstream for up to 24 hours after injection.
Switching Insulin Treatments
Consult your doctor about changing your insulin treatment plan if you experience any of the following:
- Frequent hypoglycemia (low blood sugar). Symptoms include feeling jittery, confused, weak, or clammy.
- Frequent hyperglycemia (high blood sugar). Often there are no symptoms associated with high blood sugar levels. Some people may feel excessively tired, thirsty, have blurry vision, or urinate more often.
- Your A1C or daily blood sugar readings start to swing too high or too low from the normal range for no obvious reason.
- A drastic change in your exercise regimen. This can make your blood sugar jump too high (if you stop normal activity) or too low (if you start a new exercise regimen).
- Pregnancy. It’s crucial for you to take extra care of your blood sugar during pregnancy for your own health as well as that of your unborn child. Any modifications made to your insulin should also be discussed with your obstetrician.
- A change in your sleeping routine because of a job or another reason.
- An allergic reaction to insulin, or your insulin becoming temporarily unavailable or obsolete.
Switching between types of insulin requires medical supervision, so always consult your doctor or endocrinologist beforehand.