When you first receive a type 2 diabetes diagnosis, your doctor may start you on lifestyle modifications like diet and exercise. Or you may begin taking an oral medication like metformin.
Yet eventually, insulin could become part of your treatment routine. Insulin is a hormone, and you may need it to control your blood sugar levels if they’re very high and oral drugs alone aren’t lowering them.
Insulin comes in two forms:
- Basal insulin is an intermediate- or long-acting form that keeps your blood sugar levels steady between meals and at a fasting state.
- Bolus insulin is the rapid-acting form that controls blood sugar spikes after meals.
If your doctor has recently started you on basal insulin, you can do three things to make the transition easier.
The more you know about your insulin treatment, the easier it will be to take. Make sure you understand why your doctor is putting you on insulin. Find out how this drug will help you control your diabetes more effectively.
Before you start taking basal insulin, ask your doctor these questions:
- Will I take basal insulin alone, or together with oral drugs or bolus insulin?
- What dose of insulin will you put me on?
- Will you need to adjust the dose? When might this happen?
- Can I adjust the dose myself if I need more or less insulin? Can you give me instructions on how to do this?
- When should I take insulin?
- How long will the dose last?
- What is my blood sugar target?
- How often should I test my blood sugar levels?
- What kinds of side effects can my insulin cause?
- What should I do if I have side effects?
- What happens if this form of insulin doesn’t control my blood sugar?
If you’re new to insulin, your doctor or a certified diabetes educator should teach you how to inject it. You’ll need to learn:
- how to prepare the injection
- where to give yourself the shot (e.g., in your belly, outer thigh, back of your arm, or your buttocks)
- how to store the insulin
Any change to your medication can affect your blood sugar control. And it can take your body some time to adjust to the new basal insulin. You might need to do some fine-tuning to make sure you’re on the right basal insulin dose, and that your blood sugar is staying within a healthy range.
To know whether your insulin type and dose are right, you’ll need to test your blood sugar. You might have already been testing twice or more often a day, including after meals and at bedtime. Once you start on basal insulin, you may need to test your blood sugar even more often — three to four times a day, or more to start. Ask your doctor and diabetes educator whether you should start on a new testing schedule, and for how long you’ll need to test more often.
Your doctor will also monitor your blood sugar with an A1C test. This test measures the amount of sugar attached to the protein hemoglobin in red blood cells. It gives your doctor a snapshot of your blood sugar control over a three-month period.
The American Diabetes Association recommends that you have an A1C test at least twice a year. However, you may need to have them more often to see how well the new insulin is working to control your blood sugar. Your target is to keep your A1C levels below 7 percent.
Managing your blood sugar requires keeping a careful balance between your insulin dose, the foods you eat, and the amount of physical activity you get. All three of these factors can cause your blood sugar level to rise or fall.
You might need to make a few changes to your eating or exercise routines if your blood sugar levels shift because of your new insulin dose. And you might have to adjust when you take insulin or what you eat before and during a workout so your blood sugar doesn’t dip too low during exercise.
Taking insulin can cause you to gain weight because it enables your body to use the nutrients it needs. Your doctor, a dietitian, and a physical therapist can tweak your diet and physical activity to help you manage weight gain.