What Is Diabetes? Why Is Insulin Therapy Important?

Diabetes is a chronic condition caused by the body either not making enough insulin, or the body not using insulin correctly. Insulin manages how much glucose (sugar) there is in the blood, which is the fuel/energy for our body. Diabetes is a disease of metabolism (how our body uses energy). There are four types of diabetes: type 1, type 2, gestational diabetes, and prediabetes. All forms are managed by medical care and healthy lifestyle habits.

Insulin therapy is essential to people with type 1 diabetes, as insulin is no longer being made by the pancreas, so the body does not have any insulin to help the body cells receive energy.  Insulin may also be needed to help manage type 2 and gestational diabetes. At Baptist Health, we provide care and education for people with diabetes, including education on insulin, giving insulin shots, demonstrating alternative insulin delivery devices (pumps, pods, pens), and medication management help, empowering them to live their best lives.

What Is Insulin?

Insulin is a hormone produced in a part of the pancreas known as the Islet of Langerhans. It helps convert blood sugar (or glucose) into metabolic energy. It does this by gaining entrance for glucose into the cells of the body. Insulin is also responsible for storing glucose in the liver and various muscle and fat cells. Stored glucose, called glycogen, is used by your body to fuel future energy needs.

Insulin-producing cells are sensitive to blood-sugar levels. When blood sugar rises, so does insulin production. When blood sugar falls, production slows. This helps keep blood-glucose levels within a healthy range, neither too high (hyperglycemia) nor too low (hypoglycemia), in persons with a properly regulated metabolism.

How Does Insulin Therapy Work?

Individuals with diabetes manage their blood sugar levels within a healthy range. People with type 1 diabetes require insulin because their bodies don’t produce insulin. People with type 2 diabetes may also require insulin for many reasons. People with type 2 diabetes either produce too little insulin or have insulin resistance blocking glucose absorption. Some people with type 2 diabetes think they have failed if they require insulin, however, there are many reasons why insulin may be beneficial. Also, we make less of our own insulin due to aging, which can also contribute to needing to consider insulin treatment.  Talk to your provider about options for your diabetes treatment plan. 

What Are the Different Types of Insulin Therapy?

Insulin therapy varies according to the types of insulin that a person receives. Insulin types are defined by three characteristics:

• Onset: Onset is how long an insulin takes to enter the bloodstream and begin lowering glucose levels
• Peak time: Peak time is the length of time an insulin is at maximum effectiveness
• Duration: Duration is how long an insulin continues to operate.

The chart below lists the major types of insulin used in the treatment of diabetes:

The different insulins are sometimes combined, to address blood sugar spikes at various times of the day. Consult your physician for help in determining which insulin types, and in what combinations, are right for you.

What Are the Options for Insulin Delivery?

Insulin can’t be taken orally because it would be broken down and rendered useless during digestion. To be effective, it must enter the bloodstream directly. There are several options for accomplishing this:

• Needle and syringe: Insulin is injected into the fat layer underneath the skin using a needle and syringe. Special insulin syringes are used, which have different sized syringes and needle tips, based on your needs.
• Insulin pens: Insulin pens work similarly to a needle and syringe but are convenient to travel with, and easy to use.
• Insulin pumps: An insulin pump is a small computerized device that delivers insulin in a steady, continuous dose (basal) and/or a small surge (bolus) at your prompting.  Doses are delivered through a tiny flexible tube called a catheter. The catheter is usually inserted into the abdomen, and directs the flow of insulin into the body.  An insulin pump can be programmed to increase dosages during meals or at times of stress and decrease when sleeping or less active.
• Insulin pods:  A small disposable device which holds a supply of insulin and is worn on the skin.  It too has a catheter and is programmed like a pump to deliver the right amount of insulin throughout the day.
• Inhaled insulin: Rapid-acting insulin is also available as an inhalable powder using an inhalation device.

The most common insulin injection site is the abdomen, avoiding the area 2 inches outside of umbilicus (belly button). Other sites include the back of arms, upper buttocks, and outside of thighs.  Insulin should be injected in the same general area but not in the same place.  A new needle should be used each time to avoid infection and possible necrosis.skin problems. 

It is very important to store your insulin properly and take it as prescribed.  A diabetes educator can teach you the proper method of taking insulin, how to use a delivery device (syringe, pump, pod, pen, inhaler), and how to dispose of syringes/sharps/medical waste.  It is very important to understand the correct timing of your medication, a diabetes educator can help explain your prescribed insulin plan so you get the maximum benefit of the medication.

What Are the Side Effects of Taking Insulin?

People requiring insulin therapy may or may not experience side effects, such as:

• Weight gain
• Rash, swelling, or discomfort at injection site or bumpy injection sites
• Anxiety
• Depression
• Coughing (from inhaled insulin).

Hypoglycemia (low blood sugar) is a potential side effect of insulin therapy.  This occurs when too insulin and food are out of balance.  A Registered Dietitian can help you with information on a scheduled meal plan, including snacks if needed, to help prevent hypoglycemia.  A diabetes educator can also provide you with information on how to reduce your risk of having hypoglycemia and how to treat it.  Mild hypoglycemia is easily treated in most situations by consuming 15 grams of a liquid carbohydrate to bring the blood sugar level up (examples: 4 ounces juice/soda, then following it up with a small snack. 

Frequent or severe hypoglycemia should be reported to your provider.  much insulin is injected or when not eating enough food. If severe hypoglycemia occurs (unconscious) in an individual, promptly seek emergency medical attention.

Learn More About Insulin Therapy at Baptist Health

Talk to your provider about the risks of taking any medication so you know your options.  Insulin therapy can successfully help you obtain your treatment goals by lowering your blood sugar.  New devices may taking insulin more convenient and comfortable.  There are also different types of insulin to meet your individual needs.  If you are new to insulin or considering insulin and have questions, ask your provider to refer you to a diabetes educator.