Basal insulin is normally produced during the day between meals and overnight.
Glucose (blood sugar) is made and released by the liver when you’re in a post-meal or fasting state. Basal insulin allows the cells of the body to use this glucose for energy and to keep blood sugar levels within the normal range.
People with type 2 diabetes may not produce enough, or any, insulin. They often benefit from taking long-acting insulin, which mimics the action of basal insulin.
If you take long-acting insulin injections to manage type 2 diabetes, there are certain routines that you should follow for this insulin to work most effectively.
The goal of basal insulin is to maintain a steady blood sugar level during fasting periods. Ideally, basal insulin should produce at most a 30 milligrams per deciliter (mg/dL) change when blood sugar levels are stable and in your target range during sleep times. That’s why your healthcare provider will most likely advise you to inject basal insulin at night, preferably before bedtime.
It’s recommended that people administer the injection at a regular time. Keeping consistent sleeping hours will help you and your doctor monitor how the insulin works in your body while you’re sleeping and throughout the day. This is necessary so that you can predict the window of time when the insulin is working.
Long-acting insulin is available in liquid form, and the only way to get it inside your body is by injecting it. There are two ways of injecting insulin into your body: by syringe and by pen.
If you’re using a syringe, avoid the formation of bubbles within the syringe before injection. While the bubbles in the syringe aren’t harmful, they can cause underdosing. Click the side of the syringe with your finger until any bubbles disappear.
Long-acting insulin shouldn’t be mixed with other types of insulin unless:
- you’re directly instructed by your doctor to do so
- you’re already mixing types of insulin, and you’re on a stable regimen
Insulin pens have a prefilled cartridge that contains insulin. The needles are thin and short. This provides a bit of comfort, as there’s no need to pinch the skin on the injection site to avoid injecting into the muscles.
If you’re using an insulin pen, avoid those that contain floating clumps inside the cartridge. An insulin cartridge can be used within two to four weeks without refrigeration, so make sure to always check the expiry date before using the pen.
Always check your blood sugar levels so that you can understand and keep track of how certain things affect them: exercise, different types of food, and when you take your meals, for example. This will also help you predict your blood sugar levels during the day based on your activities.
With proper and regular self-monitoring, you can avoid experiencing the side effects of having very low or very high blood sugar levels. Self-monitoring will also help you make the right decisions in terms of your insulin dosage.
The place where you inject insulin can have a huge impact on your treatment and blood sugar levels. Insulin gets transported into the bloodstream at different speeds when injected in different areas of the body. Insulin shots are fastest if injected in the abdomen, and slowest when injected in the thighs or buttocks.
Most people who have diabetes inject long-acting insulin in the abdomen since they need to do so only once or twice a day. Make sure that you avoid the area around the belly button and don’t inject exactly in the same location every time.
Injecting insulin in the same area over and over again can cause hard lumps to develop. This is known as lipohypertrophy. These hard lumps are caused by the presence of fatty deposits. In the long run, they can alter the absorption rate of the insulin.
Basal insulin dosages aren’t standard. They depend on your blood sugar levels. Make sure that you work with your endocrinologist to find out what dosage of basal insulin is right for you.
For a particular dosage, if your blood glucose level is within 30 mg/dL from bedtime until you wake up, then your dosage is most likely fine.
If your glucose level rises more than this value, you need to talk to your doctor to increase your dose. Then you need to repeat testing to monitor your blood sugar levels.
If your before-bed glucose is very high, you may need to adjust this insulin dose or one of your mealtime medication doses.
You need to continue adjusting as well as repeating your blood sugar tests until your blood sugar levels become reasonably steady at nighttime or during fasting periods.
Many people who have diabetes reuse their needles to save money. Although this carries some risks and isn’t recommended, it’s generally considered acceptable up to a certain point — especially if it’s for personal use only. Never share needles.
If you’re planning to reuse needles and lancets, make sure that you place the cover on the lancet device and syringe. Don’t try to recover the needle, as you can poke yourself. Also, don’t clean the needle with alcohol, as it can remove the needle’s silicone covering.
Dispose of a needle after using it five times, or if it is bent or has touched something other than your skin. When you get rid of needles, make sure to put them in a big, hard-plastic container that you label properly. Dispose of this container following your state’s guidelines.
Improve your body’s insulin sensitivity by embracing a healthy lifestyle. Getting plenty of exercise and eating regular meals will help your doctor establish a consistent diabetes management regimen using basal insulin therapy.
Engaging in exercise regularly or doing other physical activities can help avert extreme spikes in your blood sugar level. If you exercise only sporadically, it’s difficult to determine how your body will respond to the insulin adjustment that you need.
Meanwhile, eating regular balanced meals can help maintain steady blood sugar and avoid spikes.
Developing your own insulin injection routine is very important, and sticking with it will help you be successful in managing your blood sugar levels.