Insulin can feel intimidating—but with the right plan and a few routines, it becomes a reliable tool for steady blood sugar.
What to know
- Why insulin: If oral/non‑insulin meds aren’t enough, or if glucose is very high, insulin can quickly control levels and protect your organs.
- Types of insulin (by action):
- Rapid‑acting (e.g., lispro, aspart): starts ~10–20 min, peaks ~1–3 h, lasts ~3–5 h; used for meals and corrections.
- Short‑acting (regular): starts ~30–60 min, peaks ~2–4 h, lasts ~6–8 h; less common for meals today.
- Intermediate (NPH): starts ~1–2 h, peaks ~4–12 h, lasts ~12–18 h; sometimes used as basal.
- Long‑acting (e.g., glargine, detemir): minimal peak, lasts ~20–24 h; basal background insulin.
- Ultra‑long‑acting (e.g., degludec): lasts >24 h; flexible dosing windows in some cases.
- Basal‑bolus basics:
- Basal insulin controls fasting and between‑meal glucose.
- Bolus insulin covers meals (carbs) and corrects highs.
- Delivery options:
- Pens and syringes; smart pens can track doses.
- Pumps deliver rapid‑acting insulin continuously; some integrate with CGM as hybrid closed loop to automate adjustments.
Take action
- Injection technique:
- Rotate sites (abdomen, thighs, buttocks, upper arms) to prevent lumps (lipohypertrophy).
- Pinch up skin if needed; inject at 90° with short needles unless advised otherwise.
- Timing tips:
- Rapid‑acting mealtime insulin is often given 0–15 min before eating; earlier if pre‑meal glucose is high and food timing is certain.
- For high‑fat/high‑protein meals, discuss split dosing or extended bolus (on pumps).
- Starting and titrating basal:
- Your clinician will set a starting dose; common approach is small increases every few days based on fasting readings.
- Avoiding lows:
- Know the “Rule of 15” for hypoglycemia: 15 g quick carbs, recheck in 15 min, repeat if still low.
- Carry glucose tablets/gel; wear medical ID if recommended.
- Sick‑day and travel:
- Never skip basal insulin even if not eating; monitor more often; check ketones if Type 1 or high readings.
- Keep insulin cool but not frozen; bring extra supplies; account for time zones.
Talk to your doctor or diabetes educator about
- Your personal targets for fasting and post‑meal readings.
- Insulin‑to‑carb ratios, correction factors, and how to adjust on active or sick days.
- Whether a CGM, smart pen, or pump could simplify care.
- How to handle missed doses or delayed meals safely.
Quick glossary
- Basal insulin: background insulin covering your body’s 24/7 needs.
- Bolus insulin: dose for meals or to correct high glucose.
- Lipohypertrophy: fatty lumps under the skin from repeated injections in the same spot.
Safety note
Insulin can cause hypoglycemia—learn signs and have a plan. Never mix or substitute insulin types without clear instructions.