What You Need to Know about this Powerful Diabetes Treatment
If you have type 2 diabetes, it's likely that you'll eventually need insulin to control your blood glucose. (Approximately 40 percent of people with type 2 end up taking insulin; everyone with diabetes type 1 requires it.) Insulin may seem intimidating, but it's actually an effective therapy with few side effects. So there's no need to panic if your doctor prescribes insulin.
Despite some common misconceptions, insulin therapy does not mean you're at the end of the road, that you failed to manage your disease, or that disabling complications are just around the corner. "There is simply a point at which, no matter what we do, we can't get the pancreatic cells to produce more insulin," says Amber Taylor, MD, director of the Diabetes Center at Mercy Medical Center in Baltimore.
The good news is that there are more options than ever before. "The wonderful thing about insulin today compared to 10 years ago is that it can be individualized to accommodate when you eat, your work schedule and other aspects of your lifestyle," says Sue Cotey, RN, CDE, a certified diabetes educator at Cleveland Clinic.
Types of Insulin
Insulin is administered either via injection or via a pump that dispenses it under the skin; insulin cannot be taken by mouth because digestive enzymes break it down before it reaches the bloodstream. There are four different types of insulin:
- Rapid-acting insulin starts working about 15 minutes after injection and peaks in about an hour; the effects last about two to four hours.
- Regular or short-acting insulin hits the bloodstream within a half hour of being injected, peaks two to three hours later, and is effective for three to six hours.
- Intermediate-acting insulin reaches the bloodstream about two to four hours after injection, peaks four to 12 hours afterwards, and is effective for about 12 to 18 hours.
- Long-acting insulin starts to work several hours after injection and lowers glucose levels evenly over a 24-hour period.
Your doctor will probably prescribe more than one type of insulina "background" (intermediate- to long-acting) insulin and a "mealtime" (rapid- to short-acting) insulin. The types of insulin you get will depend on the type of diabetes you have, your blood sugar levels and how much your blood sugar fluctuates throughout the day.
New ultra-long-acting insulins are expected to be available soon. "You still inject these every day but you have a little more overlap," says Dr. Taylor. "So if you miss a dose by two or three hours, it won't have as much of an effect."
An inhaled form of rapid-acting insulin, marketed as Afrezza, has also been approved by the Food and Drug Administration (FDA). Despite the initial worries, people are usually glad they started insulin treatment. "I've had many patients tell me they never want to go off it," says Cotey. "They've never had such good control of their blood sugar."
From our sister publication Diabetes Focus Spring 2015