These are the types of insulin you take before meals. Other types of insulin are more lasting and are used for basal insulin. They take longer to affect blood sugar levels, but they provide protection for 24 hours. The strength of insulin may also vary. The most common strength is U, or units of insulin per milliliter of fluid.
People who are more insulin-resistant may require more than that, so the drug is available at up to U strength. All these factors come into play in determining the right dosage. And while doctors provide basic guidance, accidents can happen. Accidentally overdosing on insulin is not as difficult as it may seem. You might overdose accidentally if you:.
Understand the symptoms of overdose to make sure you receive the treatment you need as soon as possible. Excess insulin in the bloodstream causes cells in your body to absorb too much glucose sugar from your blood. It also causes the liver to release less glucose. These two effects together create dangerously low glucose levels in your blood. This condition is called hypoglycemia. Your blood needs the right amount of glucose for your body to operate properly.
Without it, your body is like a car running out of gas. The severity of the situation depends on how low the blood sugar level goes. It also depends on the person, because everyone reacts differently. These signs indicate a mild or moderate case of hypoglycemia.
People who have low blood sugar levels should eat 15 grams of a fast digesting carbohydrate, such as glucose tablets or a high-sugar food. High-glucose foods include:. Your symptoms should improve within 15 minutes of eating. Also, be sure to eat a meal after treating a low blood sugar reaction. More severe symptoms of hypoglycemia, sometimes referred to as diabetic shock or insulin shock, include:. If a person becomes unconscious due to too much insulin, call All people on insulin should have glucagon available.
It counteracts the effects of insulin. Insulin is a hormone that controls the level of blood sugar also called glucose 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 box below lists the different types of insulin. The goal in treating diabetes is to keep the blood sugar level within a normal range. You need to check your blood sugar level regularly using a blood glucose monitor. Your doctor or the office staff can teach you how to use the monitor.
You'll need to write down each measurement and show this record to your doctor, so your doctor can tell you how much insulin to take. Your doctor will give you a schedule. Most people with diabetes need at least 2 insulin shots a day. Some people need 3 or 4 shots for good blood sugar control. If you take Regular insulin or a longer-acting insulin, you should generally take it 15 to 30 minutes before a meal.
If you take insulin lispro brand name: Humalog , which works very quickly, you should generally take it less than 15 minutes before you eat.
Insulin lispro is a new type of insulin. It starts working sooner than other insulin types. It also reaches peak activity faster and goes away sooner. Insulin lispro helps keep your blood sugar level from going too high after you eat. To keep your blood sugar level steady, your doctor will probably prescribe either a longer-acting insulin or another drug for you to take each day in addition to the insulin lispro.
If you need to mix insulin lispro with a longer-acting insulin, it's best that you mix insulin lispro only with Humulin U or Humulin N, which are brand names for certain longer-acting insulins.
Insulin lispro should always be drawn into the syringe first. This will keep the longer-acting insulin from getting into the insulin lispro bottle. Quick-acting, such as insulin lispro Humalog , begins to work very quickly 5 to 15 minutes and lasts for 3 to 4 hours. Short-acting, such as Regular R insulin, starts working within 30 minutes and lasts about 5 to 8 hours.
Long-acting, such as Ultralente U insulin, doesn't start to work for 4 to 6 hours, but lasts 24 to 28 hours. NPH and Regular insulin mixture, two types of insulin mixed together in 1 bottle, starts working in 30 minutes and lasts 16 to 24 hours. Source: Medicine for People with Diabetes.
Insulin is normally injected under the skin with a very small needle. It can also be taken with an insulin pen. Your doctor will teach you exactly how to inject insulin, but here are the basics: Wash your hands. Take the plastic cover off the insulin bottle and wipe the top of the bottle with a cotton swab dipped in alcohol. Pull back the plunger of the syringe, drawing air into the syringe equal to the dose of insulin that you are taking measured in units. Yet, the vast majority of them believed that they were taking their insulin correctly, whereas the evidence presented here suggests otherwise.
We believe these data reinforce the need not only to ask patients what they are doing related to insulin delivery, but also to ask them to demonstrate their techniques and knowledge. Providers must reassess frequently i. Strengths of the study include direct observations of insulin self-administration technique and availability of A1C and blood glucose data from meter downloads.
One limitation is the small sample size. We hypothesize that, with a larger sample size, insulin self-administration errors would correlate with A1C and frequency of hypoglycemia, but this will require further study. Also, approximately one-third of the patients did not bring their glucose meters to the visits.
These patients were more likely to have a low income. Whether they forgot their meters or were not monitoring their blood glucose levels because of cost or other issues is not known. In conclusion, our finding that errors in self-administration of insulin are common in ambulatory adults with diabetes is of concern.
These results strongly suggest that more attention to periodically reviewing and re-educating patients concerning proper insulin self-administration should be considered, and this may be particularly important for those with lower income and education levels. Future work should focus on improving our methods and the frequency of patient education to reduce errors, which, hopefully, will decrease episodes of both hyperglycemia and hypoglycemia.
The authors wish to acknowledge the contributions of our diabetes educators and physicians, as well as our patient participants.
Weinstock has received research support through her participation in multicenter clinical trials with Calibra, Intarcia, Medtronic, Mylan, Novo Nordisk, and Sanofi. No other potential conflicts of interest relevant to this article were reported. National Center for Biotechnology Information , U. Journal List Clin Diabetes v. Clin Diabetes. Paula M. Weinstock 3. Ruth S. Author information Copyright and License information Disclaimer. Corresponding author. Corresponding author: Paula M. Trief, ude.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. This article has been cited by other articles in PMC. Abstract In Brief Incorrect administration of insulin e. Open in a separate window. Analyses Means, SDs, and simple percentages of scores on all measures were calculated for the groups.
TABLE 1. TABLE 2. Results Participants The majority of participants were female Poor Performers We examined the characteristics that discriminated between those who scored above versus below the median overall scores. Diabetes Numeracy Only Insulin-Related Behaviors Overall, Severe Hypoglycemia Approximately Discussion In this observational study of ambulatory, insulin-using adults with diabetes, we were dismayed by the high percentage of participants who demonstrated problems with site selection and rotation and reported using expired insulin, not taking recommended insulin doses, and not taking insulin at correct times—all behaviors that would likely affect glycemia.
Acknowledgments The authors wish to acknowledge the contributions of our diabetes educators and physicians, as well as our patient participants. Duality of Interest Dr. References 1. Centers for Disease Control and Prevention Age-adjusted percentage of adults with diabetes using diabetes medication, by type of medication, U.
Accessed 5 May Trends in prevalence and control of diabetes in the United States, — and — Changes in diabetes-related complications in the United States, — National trends in U. Severe hypoglycemia and diabetic ketoacidosis in adults with type 1 diabetes: results from the T1D Exchange clinic registry. National estimates of insulin-related hypoglycemia and errors leading to emergency department visits and hospitalizations. Diabetes disaster averted dialing in on insulin pens.
Accessed 28 June
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