How Does Insulin Work
Insulin is a hormone released by the pancreas and secreted into the bloodstream to manage your blood glucose levels. Insulin ensures that when glucose is not used as energy, it is stored in the cells as glycogen until needed.
The goal of diabetes management is to keep blood glucose levels as close to normal levels as possible. Normal blood sugar levels for someone with diabetes are as follows:
- Before a meal: 80-130 mg/dL
- About 2 hours after a meal starts: less than 180mg/dL
Lets say, if you have not eaten for hours, your body still needs glucose. Your body releases the stored glucose from your liver into the bloodstream. Insulin and glucagon keep your blood glucose levels in range. When high glucose is detected, insulin is released and when blood glucose level drops , the pancreas releases another hormone, glucagon, whose major function is to release the stored glucose into the bloodstream. Refer to the graphic below.
When a person doesnt have diabetes, the body releases insulin all day and overnight to keep blood glucose in a very narrow range. During meals, the body releases a burst of insulin to cover the food, especially carbohydrates that will be absorbed in the body and raise blood glucose levels. This process is done efficiently in persons without diabetes, resulting in fasting blood glucose of less than 100 mg/dl.
If you use injections, your insulin therapy schedule might look like this:
What Is Insulin And Why Do I Need It
Insulin is a hormone that controls the level of blood sugar in your body. People with diabetes may not have enough insulin or may not be able to use it properly. The sugar builds up in the blood and overflows into the urine, passing out of your body unused. Over time, high blood sugar levels can cause serious health problems.
All people with type 1 diabetes, and some people with type 2 diabetes, need to take insulin to help control their blood sugar levels. The goal in treating diabetes is to keep the blood sugar level within a normal range.
It Is Divided Into 3 Main Sections:
The modules can be read in any order.
However, if you are newly diagnosed, it is best to start at the beginning in Understanding Diabetes, and work your way through the material.
Below you will find a guide to each module.
As you will see, depending upon your individual therapy, you can choose exercise guidelines and self-management sections that are specific for your diabetes treatment. Additionally, throughout the program, Self-assessment quizzes are available to help you monitor your progress, and how much you are learning.
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Know That When You Check Your Blood Sugar The Number Tells Us How Well Your Last Dose Of Insulin Worked
For example, meal rapid-acting insulin peaks in 1 to 2 hours and lasts 3 to 4 hours. Your blood sugar taken 2 hours after the meal tells us how well the peak of the insulin covered the peak of the blood sugar after you ate. Your blood sugar taken before the next meal tells us how well the insulin worked during the time your carbohydrate was breaking down.
How Much Insulin Should I Take: Basal
For your basal dose, youll usually inject a set amount of insulin each day. The Diabetes Education and Research Center gives a formula for a general idea of how many units are needed.
The DERC first suggests calculating your total daily dose , which is the amount of insulin for your bolus and basal doses combined per day. This is calculated by dividing your weight in pounds by 4.
Then, the DERC proposes that the basal dose should be half of the total daily dose. Thus: total daily dose ÷ 2 = basal dose.
However, this is only a proposed general guideline. For a personal idea of your basal dose, you should be advised by your healthcare team, who will take other factors into account, such as the kind of insulin youre using.
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Example #: Carbohydrate Coverage At A Meal
First, you have to calculate the carbohydrate coverage insulin dose using this formula:
CHO insulin dose = Total grams of CHO in the meal ÷ grams of CHO disposed by 1 unit of insulin .
For Example #1, assume:
- You are going to eat 60 grams of carbohydrate for lunch
- Your Insulin: CHO ratio is 1:10
To get the CHO insulin dose, plug the numbers into the formula:
CHO insulin dose =
- The carbohydrate coverage dose is 6 units of rapid acting insulin.
- The high blood sugar correction dose is 2 units of rapid acting insulin.
Now, add the two doses together to calculate your total meal dose.
Carbohydrate coverage dose + high sugar correction dose = 8 units total meal dose!
The total lunch insulin dose is 8 units of rapid acting insulin.
What Is An Insulin Reaction
If youre going to use rapid-acting insulin, you need to be aware of insulin reactions and how to treat them. Rapid-acting insulin begins to work very quickly. So while you and your doctor are working to find the right dosage of this insulin, you may have some insulin reactions.
Hypoglycemia is the name for a condition in which the level of sugar in your blood is too low. If you use insulin, your blood sugar level can get too low if you exercise more than usual or if you dont eat enough. It also can get too low if you dont eat on time or if you take too much insulin. Most people who take insulin have insulin reactions at some time. Signs of an insulin reaction and hypoglycemia include the following:
- Feeling very tired.
- Being unable to speak or think clearly.
- Losing muscle coordination.
- Suddenly feeling like youre going to pass out.
- Becoming very pale.
- Losing consciousness.
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Insulin Doses Need To Be Raised Or Lowered:
- Throughout life as you grow
- For different activities
- For foods that may affect your blood sugar differently
- When you are sick
The information on the following pages may be hard to learn. Learning to change insulin doses can take time. It is important to learn this because changing insulin doses at home when needed and between diabetes appointments will help to control your blood sugar.
It is better to prevent high blood sugars than to chase them with extra insulin at the time of the high. It is better to prevent low blood sugars than to chase them with extra quick-acting carbohydrate.
Your certified diabetes educator will teach you how to change your insulin doses to prevent high or low blood sugar. We will help you by phone or email for several months after you find out you have diabetes. After you learn to change insulin doses without our help, we are still here to help you when you need.
Putting It All Together
Now that you know the how and why behind insulin dosing, lets consider how you may calculate your insulin needs.
Youll usually give yourself an insulin dose around your meals since thats when you take in carbohydrates. You also will typically check your blood sugar to see if youre meeting your premeal target dose.
To calculate your insulin needs:
You may find that if you generally eat about the same amount of carbohydrates each day, you may be able to consistently inject the same amounts of insulin outside of special occasions. It takes time to find out how your body best responds to insulin.
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Letting Stress Get To You
Your mental health plays a big role in your blood sugar level. How? Emotional stress can cause swings in your blood sugar. This is in part because stress triggers the release of a hormone called cortisol, which can impair insulin sensitivity, according to a March 2017 article in the Annals of the New York Academy of Sciences. Port says this means the same dose of basal or bolus insulin can actually be less effective if youre stressed out.
Try to identify the stressors and sources of chronic anxiety in your life. Then look for a relaxation technique that works for you. Talk to your doctor for ideas. Get consistent sleep. Listen to music. Turn off all devices at night, Port recommends. If possible, make time each day to de-stress take a yoga class, do deep breathing exercises, set aside time to read a book or relax with friends, or establish a soothing bedtime routine to help you wind down.
Total Daily Insulin Requirement:
= 500 ÷ TDI = 1unit insulin/ 12 g CHO
This example above assumes that you have a constant response to insulin throughout the day. In reality, individual insulin sensitivity varies. Someone who is resistant in the morning, but sensitive at mid-day, will need to adjust the insulin-to-carbohydrate ratio at different meal times. In such a case, the background insulin dose would still be approximately 20 units however, the breakfast insulin-to-carbohydrate ratio might be breakfast 1:8 grams, lunch 1:15 grams and dinner 1:12 grams.
The insulin to carbohydrate ratio may vary during the day.
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Set Your Carb To Insulin Ratio
Maybe you think about your insulin and meals in a much bigger way. Like, thats a four unit sandwich, or, Id need at least ten units for that meal, for example. But we need to do the work from the opposite direction to uncover a piece of the equation.
If youre counting carbs by grams, we need to know how much work a single unit of insulin can do. In other words, how many carbs can you eat for one unit of insulin? If youre counting carbs by exchanges, well ask how many units of insulin you take for one exchange.
For example, if you count 15 grams of carbs as one exchange , and would also take one unit for that, then your carb to insulin ratio is 1. If you dont know your carbs to insulin ratio, start by talking with your doctor.
He or she can help find a good place to start, and you can do some testing to fine-tune the setting. You might have different ratios at different times of the day, which you can set here as needed.
Insulin Dosages On A Fixed Dose Therapy
If you are on a fixed dose insulin therapy , your doctor or diabetes health team will help you to pick the dose, or doses, which you need to take each day.
If your blood glucose levels are running either too high or too low, contact your health team who will be able to help you make any dosage adjustments as appropriate.
Check what the recommended sugar levels are, referred to as your target blood glucose levels
insulin duration chart
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Disposal Of Used Insulin Syringes
Used syringes, pen needles, cannulas and lancets must be disposed of in an Australian Standards-approved sharps container, which is puncture-proof and has a secure lid. These containers are usually yellow and are available through pharmacies, local municipal councils and state or territory diabetes organisations such as Diabetes Victoria.
Procedures to dispose of sharps containers vary from state to state.
For sharps disposal information and help, you can contact:
- state or territory diabetes organisations, such as Diabetes Victoria
- state Department of Health
Insulin needs to be stored correctly. This includes:
- Store unopened insulin on its side in a fridge.
- Keep the fridge temperature between 2 and 8 °C.
- Make sure that insulin does not freeze.
- Once opened, keep it at room temperature for not more than one month and then dispose of it safely.
- Avoid keeping insulin in direct sunlight.
Extreme temperatures can damage insulin so it doesnt work properly. It must not be left where temperatures are over 30 °C. In summer your car can get this hot so dont leave your insulin there.
There are various insulated insulin carry bags available for transporting insulin.
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How Do I Calculate How Much Insulin To Take
In people who do not have diabetes, their bodies release insulin in response to the foods they eat. This is because many foods contain carbohydrates. Some examples include bread, sweets, fruits, and even vegetables.
Your body breaks carbohydrates down into smaller building blocks, like glucose. You need insulin to use this glucose for energy. If your body cannot make or use insulin effectively, youll need to inject it to process your food for energy.
Calculating how much insulin to take is usually based on two considerations:
- Basal insulin dose. A basal insulin dose is an amount that you give yourself daily regardless of the foods you eat.
- Bolus insulin dose. A bolus insulin dose helps correct or anticipate the carbohydrates you eat throughout the day. You will usually correct this with a bolus dose of rapid-acting insulin.
Anticipating a bolus dose is where insulin administration can get tricky. When you give yourself insulin, you are estimating how many units of insulin it will take to process the carbohydrates you eat.
The University of California, San Francisco states that, as a general rule, 1 unit of insulin will process anywhere from 12 to 15 grams of carbohydrates and lower your blood sugar by about 50 milligrams per deciliter .
Since the human body is so complex, not all people will process insulin the same way. Factors like time of day, stress levels, and physical activity can make these numbers more difficult to predict.
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What The Heck Is A Bolus
So you dont have an insulin pump, but I bet you have a smartphone.
What does that mean?
It means that you should meet mySugrs Insulin Calculator. Its a module integrated into the mySugr app that helps with your insulin doses . Btw. Insulin Calculators are also known as Bolus Calculators.
But what the heck is a bolus, you ask? Great question.
A bolus, in our case, is a single dose of insulin given all at once. In other words, its your mealtime shot or a shot to fix a high blood sugar. mySugrs Insulin Calculator examines all of the messy numbers involved and then recommends a precise dose of insulin.
At mealtime, its super easy. Measure your blood sugar, tell mySugrs Insulin Calculator about your carbs, and well do the rest. Well even keep track of your active insulin . All you have to do is dial up the dose and take it.
Never heard of active insulin? Its a concept that helps reduce hypos caused by stacking insulin. Well explain it in more detail below.
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How Much Insulin To Take For Bodybuilding
Injecting insulin is not a safe approach to weight training. However, some bodybuilders will inject it as a performance-enhancing drug. They believe injecting insulin will allow energy in the form of glucose to enter their cells so they can build more muscle.
This practice is unsafe and can lead to severe and potentially life threatening hypoglycemia, according to 2019 research.
You should not take insulin unless you have diabetes. If you do have diabetes, talk with your doctor about how your training regimen may affect your blood sugar levels.
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How To Take Long
Usually, you inject long-acting insulin once a day to keep your blood sugar levels steady. You use a needle or pen device to give yourself the injection. Be sure to inject your long-acting insulin at the same time every day to avoid lags in insulin coverage or stacking your insulin doses. Stacking means taking your doses too close together, causing their activity to overlap.
Your doctor might recommend adding short-acting insulin before a meal to prevent a blood sugar spike after you eat.
If you change brands of long-acting insulin, you may need a different dose. Talk to your doctor if you change brands of any insulin.
As with any medicine you take, insulin injections can cause side effects.
One possible side effect is low blood sugar . Symptoms of low blood sugar
Matching Insulin And Food
In addition to understanding an insulins action curve, its important to understand how the food you eat affects your blood glucose level so that you can match your insulins action to the expected rise in blood glucose level following a meal. In general, people with normal stomach emptying can expect some glucose from the carbohydrate theyve eaten to start raising their blood glucose level within minutes of starting to eat. Blood glucose level tends to peak about one to two hours after the start of a meal and gradually drops over the next three hours.
Some other factors that may cause insulin action to differ from the action curve given in product literature or to vary from person to person include thickness of the subcutaneous fatty layer at an injection site, temperature, blood flow, exercise, and dose size. Injecting into areas that have more subcutaneous fat tends to slow insulin absorption. Widened blood vessels allow insulin to be absorbed more quickly constricted blood vessels can cause slower absorption. Large doses of insulin may also be absorbed somewhat more slowly than smaller doses.
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