Insulin and Administering Insulin

Administering insulin is an important component of diabetes self management for type 1 and some type 2 diabetics. Patients with type 1 diabetes do not have the ability to produce adequate amounts of insulin, therefore insulin injections are required. Type 2 diabetics may or may not need insulin depending on the disease progression.

What is insulin? Insulin is a hormone produced by the pancreas. It interacts with the food we eat to change sugar and starches and other types of foods into fuel for our bodies. It is estimated that 5 percent of people with diabetes have type 1 diabetes and are unable to produce insulin. [1]

Among adults diagnosed with type 1 or type 2 diabetes, 12 percent take insulin. Fourteen percent take insulin in addition to an oral diabetic medication. [2]

When a Person is Unable to Produce Insulin

Diabetics who cannot produce insulin or don’t produce enough must rely on insulin treatments or insulin therapy. This involves administering insulin using the injection method, a pen and injection device, or an external insulin pump.

Different types of insulin are available for diabetics. Insulin types are based on how quickly they work, how soon they peak, and the length of time they last.[3]

When learning about insulin injections, you will need to know three new terms: onset, peaktime, and duration.

The onset refers to the amount of time that passes before the insulin injection reaches the bloodstream. This is the time that must pass before the insulin can begin working.

The peaktime is the time when the insulin is most dominant. This is when it performs the best. Peaktime is normally more than an hour after onset.

Duration is the length of time the insulin injection will continue to lower the blood sugar. Different types of insulin have different duration times. The insulin with the longest duration time also has the longest onset time. This means it takes the longest to start to work even though it lasts the longest in the bloodstream.

Let’s look at the different types of insulin your doctor might recommend:

  • Rapid acting: this type of insulin will start to work almost right away. On average, it takes about 5 minutes for the patient to feel the effects of the insulin after the injection. Rapid acting insulin peaks in 30-90 minutes and lasts for up to 5 hours.
  • Short acting: this type of insulin begins to work in about one-half hour. Regular acting insulin is often called short acting insulin and peaks in 2 hours. It can last for up to 6 hours.
  • Intermediate acting: it takes this form of insulin anywhere from 1 to 4 hours to get into the bloodstream after an injection. The peak time can be in as little as 4 hours or up to 12 hours from the injection time. Its effectiveness lasts up to 16 hours.
  • Long acting: this type of insulin takes about 1-2 hours to onset and has no peak. However, it is effective for longer than any other form – up to 24 hours.

Self Managing Insulin

Your doctor will work with you to determine what type of insulin you need and help you develop a regimen that will keep your blood glucose stable.

Recent technology has made it easier than ever to deliver insulin to your body when you need it and wherever you need it. Formerly, injections by needle were the only option for self management of diabetes. This was a cumbersome method of managing the disease that required patients to carry syringes and needles along with glass vials of insulin and antibiotic swabs or tissues. Many diabetics felt like they were carrying their own ‘mini lab’ whenever they left home and it interfered with quite a few patients’ social lives.

The development of the insulin pen has made it much easier to self manage diabetes and insulin injections. The insulin injection pen looks like a writing pen. It has a empty section for holding an insulin cartridge. The pen injection method is very flexible. Cartridges are available in all forms of insulin and the amount of insulin to be injected by the patient is easily determined. The pen has a dial that allows the diabetic to manage the exact units of insulin every time.

The pen injection method is hypoallergenic. The top of the unit, (the pen), is a replaceable tip. Every time the pen is used the patient can replace the tip and dispose of the used tip and cartridge.

Another technological advance in diabetic care is the external insulin pump. This pump is operated by a mini-computer chip and allows the patient to get the correct dose every time.[4] The external insulin pump is comparable in size to a small cell phone and runs on battery power.

External insulin pumps are normally attached to the skin in the abdomen area. A small plastic tube leads from the pump. At the end of the tube is a tiny cannula that is positioned under the skin. This is removed every two days to put a new cannula in place for hygienic reasons.

One of the most interesting aspects of the pump is that is delvers insulin to the patient on a constant basis. The rate may raise and lower depending on activity levels and the pump can be programmed for each person. For example, it can send more insulin through the cannula at mealtimes to compensate for carbs and sugars.

Many devices are currently being tested that will eliminate the need to inject insulin using a needle and syringe. Jet injectors are one of the most exciting types of new injectors in this field of study. Researchers originally saw that jets of oil under great pressure could penetrate the skin with no pain. They are using this technology to develop jet injectors for insulin.[5]

Insulin, in whatever form, is life saving for many diabetics. If you have been diagnosed with diabetes and must take insulin, work with your doctor to determine the type of insulin you need, when you need it, and the method you will use to get insulin into your bloodstream.

References

[1]  National Diabetes Statistics. (n.d.). Retrieved from US Department of Health and Human Services: http://diabetes.niddk.nih.gov/DM/PUBS/statistics/#fast

[2]  Treatment of Diabetes. (n.d.). Retrieved from NDIC: http://diabetes.niddk.nih.gov/dm/pubs/statistics/index.aspx#Treatment

[3]  National Diabetes Statistics, op. cit.

[4]  Alternative Devices for Taking Insulin. (n.d.). Retrieved from NDIC: http://diabetes.niddk.nih.gov/dm/pubs/insulin/

[5] Owens, D. (n.d.). New Horizens: Alternative Routes for Insulin Therapy. Retrieved from DR Owens – Nature Reviews Drug Discovery, 2002 – medicina.iztacala.unam.mx

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.