Insulin Shots Type 2 Diabetes

Managing Diabetes With Insulin

Injections of insulin can help manage both types of diabetes. The injected insulin acts as a replacement for, or a supplement to, your bodys natural insulin.

People living with type 1 diabetes cant make insulin, so they must inject insulin to control their blood glucose levels.

Many people living with type 2 diabetes can manage their blood glucose levels with lifestyle changes and oral medication. However, if these treatments dont help control glucose levels, people living with type 2 diabetes may also need supplemental insulin.

How Are Doses Scheduled

Follow your doctor’s guidelines on when to take your insulin. The time span between your shot and meals may vary depending on the type you use.

In general, though, you should coordinate your injection with a meal. You want to time your shot so that the glucose from your food gets into your system at about the same time that the insulin starts to work. This will help your body use the glucose and avoid low blood sugar reactions. From the chart on page 1, the “onset” column shows when the insulin will begin to work in your body. You want that to happen at the same time you’re absorbing food. Good timing will help you avoid low blood sugar levels.

• Rapid acting insulins: About 15 minutes before mealtime
• Short-acting insulins: 30 to 60 minutes before a meal
• Intermediate-acting insulins: Up to 1 hour prior to a meal
• Pre-mixed insulins: Depending on the product, between 10 minutes or 30 to 45 minutes before mealtime

Avoiding Injection Bruises And Lumps

Bruising can happen when you catch a tiny blood vessel under the skin where you have injected. It is quite normal for this to happen occasionally when you are injecting regularly and youre not doing anything wrong.

If you are concerned, you could make an appointment with your diabetes specialist nurse who will be able to do a review of your injection technique. In some cases, bleeding and bruising can be reduced by something as simple as using a different sized needle or changing your needle after each injection.

Some people notice hard lumps that can form if you inject in the same place too often. This might be lipohypertrophy , or could be something called cutaneous amyloidosis. These lumps can stop the insulin from working properly, so make sure you rotate where you inject and choose a different spot each time. If you notice any lumps, especially if theyre not going away, speak to your healthcare professional for more advice.

Other side effects from injecting a lot can be itching, rashes and other skin irritations. Changing where you inject helps with this too. You can also get treatments from your local pharmacy that can will help with the irritation.

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How Do I Take And Adjust My Insulin Doses

It is important to learn the different methods of taking insulin and what kinds of insulin can be delivered through each method. There are several ways to take insulin syringe, pen, pump, or inhalation though injection with a syringe is currently the most common for people with type 2 diabetes. There are many apps that can help you calculate your insulin doses.

Your insulin regimen should be tailored to fit your needs and lifestyle. Adjusting your basal insulin dosage and timing will require conversations and frequent follow-up with your healthcare team. When initiating insulin therapy, you may be advised to start with a low dose and increase the dose in small amounts once or twice a week, based on your fasting glucose levels. People with diabetes should aim to spend as much time as possible with glucose levels between 70-180 mg/dl. Insulin may be used alone or in combination with oral glucose-lowering medications, such as metformin, SGLT-2 inhibitors, or GLP-1 agonists.

One of the most important things to consider is the characteristics of different insulin types. To learn more, read Introducing the Many Types of Insulin Is There a Better Option for You? and discuss with your healthcare team.

In order to dose insulin to cover meals or snacks, you have to take a few factors into consideration. Your healthcare team should help you determine what to consider when calculating an insulin dose. Prandial insulin doses will usually be adjusted based on:

What Is Good About Insulin Pens As Opposed To Syringes

Insulin pens are very easy to use. They are great for young diabetics who need to deliver insulin at school. Furthermore, many diabetics find insulin pens almost painless. They are also portable and discreet, as well as not being as time-consuming as syringes. An accurate dose can be pre-set on the dosage dial, which can be useful for diabetes sufferers who also have impaired vision.

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Ozempic And Other Medications

Below is a list of medications that can interact with Ozempic. This list does not contain all drugs that may interact with Ozempic.

Before taking Ozempic, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

• Drugs that increase insulin. Taking Ozempic with drugs that increase insulin levels in your body can cause hypoglycemia . Examples of these drugs include:
• insulin degludec

Ozempic helps improve blood sugar levels in people with type 2 diabetes. It does this by reducing the amount of glucose in your blood.

Checking Your Blood Sugar

Your meals, medicine, and exercise all revolve around your blood sugar. So youâll need to test it regularly.

Your doctor will tell you how many times to do it each day. Itâll depend on the kind of diabetes you have and how much insulin or other medicine youâre taking.

If youâre taking insulin several times a day, you may need to do a test before each meal and before you go to bed.

If youâre taking long-acting insulin, you may only need to test before breakfast and before dinner.

If youâre taking other medicine but not insulin, you may not need a test every day.

Keep extra-close watch on your blood sugar if you do vigorous exercise. Physical activity can affect your level for hours even the next day. You may need to check your blood sugar before, during, and after each workout.

Show Sources

Joslin Diabetes Center: âDiabetes and Scheduling: Starting a Routine,â âOral Diabetes Medications Summary Chart.â

National Institute of Diabetes and Digestive and Kidney Diseases: âManaging Diabetes,â âDiabetes Diet, Eating, and Physical Activity.â

Kaiser Permanente: âWhat to Eat, How Much, and When,â âAction Plan for Healthy Eating.â

Mayo Clinic: âDiabetes management: How lifestyle, daily routine affect blood sugar,â âDiabetes,â âBlood sugar testing: Why, when and how.â

Food & Nutrition: âMeal Times and Diabetes: Whatâs the Connection?â

Medicare.gov: âYour Medicare Coverage: Nutrition therapy services .â

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It Can Take Time To Develop An Insulin Regimen

If youve been prescribed insulin therapy, it can take a little trial and error to learn what types and dosages of insulin work best for you. Blood sugar tests can help you and your doctor learn how your body is responding to your current insulin regimen. If needed, your doctor can make changes to your prescribed treatment plan.

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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Side Effects Of Trulicity

Common side effects of Trulicity include stomach pain, indigestion, diarrhoea and loss of appetite. If you experience hives, difficulty breathing, or swelling, you may be allergic to Trulicity. You should seek emergency medical help immediately. If you feel any severe pain in your upper stomach, vomiting, or quickened heart rate, this could be a sign of pancreatitis Speak to your doctor about this as soon as possible.

Other signs of serious aversion to Trulicity include swelling or a lump on your neck, low blood sugar the symptoms of which are explained here or signs of a kidney problem, such as painful urination and swelling in your feet or ankles. If you experience any of these, speak to your doctor as soon as possible.

Rest assured that serious aversions to Trulicity are rare. They are listed here only on the off-chance that they affect you. Theres no need to worry about them unduly.

Insulin Is A Treatment Of Last Resort

Although some people exhaust all possible diabetes treatments before resorting to insulin, this may not be the best strategy. By the time a person with type 2 starts insulin therapy, they likely already have diabetes-related complication because of poor blood sugar control, Dr. Crandall says. Because high blood sugar is so toxic and can up the risk of heart attack, stroke, and other problems, you shouldnt waste too much time undergoing treatments that arent getting your blood sugar under control.In fact, starting insulin sooner may avoid complications, cause oral medications to work better , or allow you to use a less-complicated insulin regimen for a longer period of time.

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New Medication The First Approved Diabetes Drug To Target Both Gip And Glp

The drug is the first approved medication that targets two principal natural incretin hormones, GIP and GLP-1. Incretins are metabolic hormones that stimulate a decrease in blood glucose levels.

The approval was based on results from the phase 3 SURPASS program, which included head-to-head comparisons to the injectable Ozempic 1 milligram , as well as comparisons with long-acting insulin analogs Lantus and Tresiba . At the end of seven different phase 3 trials that lasted between 40 and 52 weeks, Mounjaro produced superior A1C reductions versus all comparators.

Mounjaro appears to represent an advancement over current GLP-1 analogues, providing enhanced glycemic and weight benefits without an added penalty in terms of gastrointestinal adverse effects, stated a after the publication of one of the phase 3 trials.

Mounjaro has not been studied in patients with a history of pancreatitis and is not indicated for use in patients with type 1 diabetes mellitus.

Throwing Away Your Needles And Lancets

Sharps bins and needle clippers are the safest way of disposing of your insulin needles and your lancets. A needle clipper removes the needle from your insulin pen, and is useful when youre out and about. How you get rid of your sharps bin depends on where you live. Your healthcare team should have information to help you get rid of your bin.

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What Classes Of Diabetes Medications Should Be Avoided Together

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Air and light should be paid attention to prescription medicine for diabetes type 2 when speaking. However, the indoor temperature and the seats of the audience must also be paid attention to.

What Is Type 2 Diabetes

Type 2 diabetes is a disease where your body cant use energy from food properly. Your pancreas produces insulin to help your cells use glucose . But over time your pancreas makes less insulin and the cells resist the insulin. This causes too much sugar to build up in your blood. High blood sugar levels from Type 2 diabetes can lead to serious health problems including heart disease, stroke or death.

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Before Using Ozempic Tell Your Health Care Provider If You Have Any Other Medical Conditions Including If You:

• have or have had problems with your pancreas or kidneys.
• have a history of diabetic retinopathy.
• are pregnant or breastfeeding or plan to become pregnant or breastfeed. It is not known if Ozempic® will harm your unborn baby or passes into your breast milk. You should stop using Ozempic® 2 months before you plan to become pregnant.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and other medicines to treat diabetes, including insulin or sulfonylureas.

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Learn How To Inject Insulin

Insulin can be injected using a syringe, but most people use insulin pens. Insulin pens are similar in size and shape to a writing pen. They make measuring and injecting your insulin easier and are easy to carry around. Insulin pens are not pre-fitted with needles. A suitably sized needle has to be attached to the pen. Insulin should be injected into the fatty tissue under your skin. Your abdomen or tummy area, about 5 cm away from your belly button, is usually a good place. It is easy to reach and insulin absorbs well from this site. Read more about how to inject insulin.

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What Other Drugs Will Affect Ozempic

Semaglutide can slow your digestion, and it may take longer for your body to absorb any medicines you take by mouth.

Tell your doctor about all your other medicines, especially insulin or other diabetes medicine, such as dulaglutide, exenatide, liraglutide, , Trulicity, Victoza, and others.

Other drugs may interact with semaglutide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Calculations And Statistical Analyses

Plasma lispro measurements were used to estimate absorption rate constant , maximum plasma concentration , time to maximal concentration , area under the lispro plasma concentration curve , Cmax to dose ratio , AUC0- to dose ratio , volume of distribution , clearance , half-life , and mean residence time. Calculations were performed assuming a noncompartmental distribution using the WinNonlin 5.2 software .

Using glucose infusion rate versus time data, the maximum glucose infusion rate , time to maximum glucose infusion rate , and total glucose infusion from injection to end of clamp were calculated.

The study comprised one experiment in healthy subjects and three in obese subjects with type 2 diabetes in the latter subjects, 10-unit experiments were used as control for comparison with larger dosages. Results not normally distributed, based on the Normal Quintile Plot, were log-transformed for all statistical analyses and reported back-transformed in their original units. Values of P< 0.05 were considered significant.

For correlations between parameters that were repeatedly assessed at multiple insulin dosages in the same patients, repeated-measures ANOVA tests considering clustering of multiple measurements were used. All adjustments were performed again by multivariate ANOVA tests. Data calculations and statistical analyses were performed using JMP 7.0 software .

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What Medicines Might I Take For Diabetes

The medicine you take depends on the type of diabetes you have and how well the medicine controls your blood glucose levels, also called blood sugar levels. Other factors, such as any other health conditions you may have, medication costs, your insurance coverage and copays, access to care, and your lifestyle, may affect what diabetes medicine you take.

Titration And Timing Of Basal Insulin

After the recent unexpected finding of increased mortality in the intensive glucose-lowering therapy group of the ACCORD study, which might be partly related to the rate of the reduction in A1C , clinicians may now be more reserved to lower glucose levels promptly. However, we still feel that in addition to timely initiation, rapid titration of the dose is indispensable for successful insulin therapy. The ACCORD study solely included patients at high risk for cardiovascular disease, in whom low A1C levels were reached by using up to four or five different classes of glucose-lowering drugs. In contrast, in less selected patients treated with stable doses of one or two oral agents, simple titration algorithms targeting fasting plasma glucose 100 mg/dl can safely achieve A1C of 7.0% . A patient-driven algorithm, with patients increasing their insulin dose by 2 or 3 units every 3 days, as long as their fasting plasma glucose remains above target, constitutes a practical approach that has been shown to be equally or more effective than physician-led titration .

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