What to Expect When Changing Your Insulin Treatment

Learn about your insulin

It’s important to talk to your doctor, healthcare team, and certified diabetes educator about your insulin, medication regimen, and schedule. Try to learn everything you can about the type of insulin you’ll be taking, including possible peaks of action and potential side effects. You’ll feel more in control of your diabetes management once you understand how your new insulin works and how to incorporate it into your daily schedule.

Many different types of insulin are available. Your doctor may prescribe one or more types of insulin to help manage your type 2 diabetes:

• You take rapid-acting insulin when you’re ready to eat a meal, usually
  within 15 minutes of eating, to counteract the rise in blood glucose from
  the food you eat. If you have type 2 diabetes, you may take rapid-acting
  insulin along with long-acting insulin.
• Regular or short-acting insulin takes about 30 minutes to
  take effect, which is a little longer than rapid-acting insulin. You also take
  it before a meal.
• Intermediate-acting insulin covers your insulin requirements for
  approximately half of the day or night. People often combine it with a
  shorter acting insulin.
• Premixed insulin
  is a combination of a rapid-acting and intermediate-acting insulin. Some
  people use this type of insulin to cover both basal and mealtime insulin
  requirements.

Long-acting insulin

Long-acting insulin is designed to cover your insulin needs for one full day. Many people with type 2 diabetes have very little or no basal insulin. This is a steady, small amount of insulin that the pancreas normally releases all day. If you have type 2 diabetes, you may need a dose of long-acting insulin to help cover your insulin needs throughout the day and overnight. It’s important to note that many people with type 2 diabetes may need to split the dose of this type of insulin or combine it with a short-acting insulin to improve blood sugar management.

No matter what type of insulin you’re taking, you should follow your doctor’s recommendations for checking your blood sugar levels.

Know your dosage

Your doctor and healthcare team will want to work closely with you to figure out the best treatment plan for your diabetes management. This includes your insulin dosage.

Your dosage will depend on your:

• weight
• age
• metabolic
  requirements
• health
  status
• current
  treatment plan

Even if you’ve been on insulin before, it’s important to work with your doctor now that you’re starting a new type of insulin or a new dosage or insulin regimen. Your certified diabetes educator (CDE) or doctor will help you adjust your dosage based on your blood sugar response over time.

Closely monitor and log your blood sugar levels, so that you can discuss them with your healthcare team and fine tune your insulin dosage as needed. Always discuss potential adjustments in your insulin dosage with your healthcare team. The information you provide to your doctor is vital to your care and diabetes management.

Be aware of symptom changes

Starting a new insulin may initially cause symptoms. Make sure to discuss any unusual symptoms with your doctor. Be honest and share any of these symptoms, or any other problems that may occur with your new insulin as soon as they occur.

Here are some questions to consider:

• Do you feel anxious, confused, sweaty, or weak?
  You might have a low blood sugar or hypoglycemia.
• Do you feel fatigued, thirsty, and you can’t
  stop running to the bathroom due to frequent urination? You may have a very
  high blood sugar or hyperglycemia.
• Have you noticed that your blood sugars are
  fluctuating out of range throughout the day?
• Have you started a new exercise routine at the
  same time you changed your insulin or insulin dosage?
• Have you been under a lot of stress? Has this affected
  your sleep patterns or eating schedule?

Manage weight gain

Sometimes, people gain weight when they begin to use insulin or start on a new dosage of insulin. The reason for the weight gain is that when you weren’t taking insulin, your body wasn’t using the glucose or sugar from your food for energy, and instead built up in your blood, causing high blood sugar. Now that you’re taking insulin, the glucose is going into your cells as it should, where it’s used or stored as energy. You may have also previously been somewhat dehydrated, and may now be retaining some extra fluid, which may result in some weight gain.

Follow these tips to minimize weight gain:

• Eat
  smaller portions. Consider meeting with a registered dietitian nutritionist
  (RDN), preferably one who is also a CDE, to help you manage your current meal
  plan.
• Be
  more physically active to burn more calories and cut down on stress. Remember
  to test your blood sugar before, during, and after exercise and discuss the
  results with your doctor
• Talk
  to your doctor about the weight gain before it becomes an uncomfortable issue. Don’t
  try to adjust your insulin or medications on your own as this may adversely
  affect your treatment plan.

Managing your type 2 diabetes can be hard work, but it’s not impossible and you’re not alone. Taking insulin along with making healthy lifestyle changes such as eating a nutritious diet, exercising, and managing stress are important parts of your diabetes management plan. Remember to ask your healthcare team questions and voice any concerns regarding your new insulin routine and diabetes care.