Basal insulin is normally produced during the day between meals, and overnight. Glucose is made and released by the liver when you are 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, and often benefit from taking long-acting insulin, which mimics the action of this basal insulin. If you take long-acting insulin injections to manage your type 2 diabetes, there are certain routines that you should follow in order to maximize efficacy.
Tip #1: Have a sleep routine
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 mg/dl change when blood sugar levels are stable and in your target range during sleep times. That’s why you should inject basal insulin at night, preferably before bedtime.
It is recommended to administer the injection at a predictable sleeping time. Keeping consistent sleeping hours will help you and your doctor monitor how the insulin works in your body while you are sleeping and throughout the day. This is necessary so that you can predict the window of time when the insulin is working.
Tip #2: Pen vs. syringe
Long-acting insulin is available in liquid form and is clear. 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 pen.
If you are using a syringe, avoid the formation of bubbles within the syringe before injection. The bubbles in the syringe are not harmful, but they should still be avoided because they can cause underdosing. With the presence of bubbles, you might not be injecting the right amount of insulin. Click the side of the syringe with your finger until any bubbles disappear. Also, these types of insulin should not be mixed with other types of insulin unless directly instructed by your doctor to do so (if you are already doing this and on a stable regimen).
Insulin pens have an attached cartridge that contains insulin. The needles are thin and short. This provides a bit of comfort to the patient. There is no need to pinch the skin on the injection site to avoid injecting into the muscles.
If you are using an insulin pen, avoid those that contain floating clumps inside the cartridge. An insulin cartridge lasts between two and four weeks, so make sure to always check the expiry date before using the pen.
Tip #3: Self-monitor
Always check your blood sugar levels so that you can understand and keep track of how exercise and different types and timing of food affect your levels. 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.
Tip #4: Rotate the injection site
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 at different areas of the body. Insulin shots are fastest if injected in the abdomen, and slowest when injected on the thighs or buttocks.
Most people who have diabetes inject long-acting insulin in the abdomen since it is only a once or twice a day injection. Make sure that you do not inject exactly on the same location every time, and avoid the area around the bellybutton.
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.
Tip #5: Always work with your endocrinologist
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 instance, if your blood glucose level is within 30 mg/dl from bedtime until you wake up for a particular dosage, then your dosage is most likely healthy. 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.
Tip #6: You can reuse needles, but…
Many people who have diabetes reuse their needles to save money. This carries some risks and is not recommended, but is generally considered acceptable up to a certain point, especially if it is for personal use only. Never share needles. If you are planning to reuse needles and lancets, make sure that you place the cover on the lancet device and syringe. Do not try to recover the needle, as you can poke yourself. Don’t clean it with alcohol, which can remove the silicone covering of the needle.
Dispose of the needles after using each one more than five times, or if it is bent or has touched something other than your skin. When you dispose of needles, make sure to store them in one big, hard plastic container and put proper tagging on it. Dispose of it following your state’s guidelines.
Tip #7: Maintain a healthy lifestyle
Improve your body’s insulin sensitivity by embracing a healthy lifestyle. Having a regular exercise regimen and eating regular meals will help your doctor establish a consistent diabetes management regimen using basal insulin therapy.
Engaging in regular exercise or doing other physical activities can help avert extreme spikes in your blood sugar level. If you exercise only sporadically, it is difficult to determine how your body will respond to the insulin adjustment that you need. Eating regular balanced meals, meanwhile, 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.