Insulin is a commonly prescribed medicine in patients with type 2 diabetes. In the initial stages of treatment, patients are often prescribed just medication in the form of tablets, and if the blood sugars remain out of control the patient may need insulin.
Here, we discuss 10 important-to-know facts about insulin that all patients on the drug must know.
#1 Being on Insulin can be a good thing
It is a common misconception that starting insulin injections to manage type 2 diabetes is a bad thing. Doctors all across India often face hesitation from patients when a suggestion is made that they start insulin.
The truth of the matter is that starting insulin can be a good thing, especially if you are serious about taking control of your blood sugar levels. Starting insulin just means that you need better control of your blood sugar levels, that’s all. In addition to taking medicines, taking insulin means that you can regulate your sugars in a more controlled and predictable manner.
However, bear in mind that taking insulin is a not a ticket to eating sugar-rich foods. You will still need to be very strict with your diet and follow a good exercise plan.
#2. Insulin vials must be stored in the refrigerator
Insulin is very sensitive to changes in temperature. For this reason, it is strongly recommended that insulin vials that remain unused must be stored in the refrigerator. There are always instructions on the package that you must follow.
If you have opened a vial, then you must store it at temperatures below 25 degrees C. However, this may not be possible in India given our temperate climate, so storage in a fridge is advised. Do not freeze insulin.
On the other hand, insulin pens can be stored at room temperature and do not need refrigeration.
#3. Insulin injections are painless
Many of us fear needles, and dread the thought of having to inject insulin into the skin everyday for the rest of our lives. This fear is natural; after all, who does not have childhood memories of being injections?!!
But fear not, insulin injections are virtually painless. Modern technology and advances in diabetes research now mean that needles are so small and fine that they feel no worse than a mosquito bite (with the annoying itching of course!).
In addition to this, the needles are now coated with silicone, which allows them to easily slide through the skin into the tissue beneath it. The injections are given into the fat tissue that is present in the abdomen or inner thigh, where pain sensation is minimum.
If you are apprehensive, then get a friend or family member to give you the injections.
#4 Make sure you use the right vial and syringe
Insulin comes in vials of 100 IU/ml and 40 IU/ml. Syringes also come in sizes suited for these volumes.
An insulin syringe that is suited for a 40 IU/ml dose must be used with a 40 IU/ml vial. Similarly, a 100 IU/ml syringe must be used with a 100 IU/ml vial.
Make sure you note this when you start using insulin. Using the wrong syringe-insulin match can result in administration of the wrong dose, which can be harmful.
#5 Never increase your dose without advice
Some people take it for granted that eating sweets means a higher dose of insulin is required. This is wrong.
Firstly, if you are diabetic, then sweets are a complete ‘no-no’. They not only increase your sugar levels; they also can increase your blood cholesterol. However, it is human to succumb to temptation, so it is understandable why some might want to have a sweet or two at a family function.
If you feel you have crossed the line with your diet, then speak to your doctor. It is always a good idea to monitor your blood sugar levels at home, and check your levels before ringing your doctor. This way, they can give you the best advice about what dose of insulin (if you need it) you must be taking.
Patients who have had diabetes for a number of years and have been managing their condition with insulin build experience over the years on how to control their blood sugars. These patients will know what dose to take when they eat less (or more) food so that they can keep the blood sugars under control.
#6 Avoid a hot water bath after insulin injections
In the immediate period after taking your insulin injections, it is not advised that you take a hot water bath.
Having a hot water bath causes the insulin to act faster, leading to a quicker drop in blood sugar levels. This is because the hot water dilates the blood vessels under the skin, leading to quicker absorption of the drug. This can be harmful.
It is recommended that all patients wait 1 – 2 hours after insulin injections to take a hot bath.
However, if you have just had a hot water bath and are yet to have insulin injections, then wait 15 minutes to do so.
#7 Look after your insulin when you travel
As we have previously mentioned, it is essential to keep insulin stored at ideal temperatures. However, when travelling, this may not be possible.
Firstly, never put your insulin in the check in baggage. Sub-zero temperatures in the cargo area can freeze the insulin, reducing its potency. If travelling by road, never place insulin in direct sunlight. The glove compartment or boot (trunk) of the car is not advised either.
Instead, you can carry your insulin in cold packs or travel packs, along with the other equipment you need to inject the drug. The image below is an example (click on it to see the product).
#8 Always change the site where you inject insulin
Remember the sites we mentioned above? Insulin injections are best injected into the abdominal fat around the umbilicus, inner thigh and upper arm.
Constantly injecting insulin into the same site can increase the amount of fat tissue present in that area. This is called lipo-hypertrophy (lipo = fat, hypertrophy = growth). Make it a point to pinch the skin and inject into it to avoid injecting directly into the muscle. Injecting insulin into the muscle can speed up absorption of the drug and can lead to hypoglycemia i.e. low blood sugar.
By injecting insulin into areas where there is excessive fat deposition, the absorption of the drug is unpredictable. Too little may be absorbed, and blood sugar levels can remain high.
In order to prevent this from happening, make sure you change the site of injection every day. For example, inject into the thigh one day, abdomen the next and arm the next. Repeat this cycle but at different sites.
Finally, never massage the site where you have injected insulin. This can increase the speed at which it is absorbed, leading to a drop in blood sugar levels.
#9 Insulin can increase your body weight
Before you jump to conclusions, the increase in body weight is not a bad thing.
Taking insulin helps breakdown the sugars in the body in a better manner. These sugars are then available to the cells as energy. Prior to starting insulin, it is common for a lot of this extra sugar in the body to be lost in the urine. This process stops when you start insulin.
If you are worried about weight gain, don’t be. Weight can be well controlled through a good diet and exercise plan. Seeing a dietician may be a good idea.
#10 Starting insulin does not mean you have to take it for life
Just because you have started insulin, it does not necessarily mean you will have to take it your entire life.
When type 2 diabetes is diagnosed, patients who have high blood sugars may be started on insulin injections so that quick control of blood sugars can be obtained. Once the sugars are controlled, these patients are switched over the tablets and the insulin is stopped.
If you have recently started insulin (having been on tablets before), then you can come off it eventually if you are very strict with your diet and exercise plan. Reducing weight is often accompanied by reduced doses of insulin.
Starting insulin can be a good thing for diabetes. It can help you achieve better control of your blood sugars and can make you feel healthier as well.