What Should I Know About Side Effects Of Diabetes Medicines
Side effects are problems that result from a medicine. Some diabetes medicines can cause , also called low blood glucose, if you dont balance your medicines with food and activity.
Ask your doctor whether your diabetes medicine can cause hypoglycemia or other side effects, such as upset stomach and weight gain. Take your diabetes medicines as your health care professional has instructed you, to help prevent side effects and diabetes problems.
When Do I Take Rapid
You should inject rapid-acting insulin no more than 15 minutes before you eat. Your doctor will tell you how much insulin to inject. Remember, you should not wait more than 15 minutes to eat after you take this insulin shot.
Rapid-acting insulin can be more convenient to take than regular insulin. With regular insulin, you inject the insulin and then wait 30 to 60 minutes before eating. Many people find it hard to time their meals around regular insulin injections. Sometimes they end up eating too soon or too late. Then they dont achieve the best blood sugar control. Since rapid-acting insulin is taken so close to mealtime, it may help you control your blood sugar more effectively.
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:
Insulin Sensitivity And Your Dose
You may hear your healthcare professional talk about insulin sensitivity. This is how well your body is using insulin to get your blood sugar levels down. People with high sensitivity need less insulin than those with low sensitivity.
Your healthcare professional can test you for insulin sensitivity, and this will help them decide what dose of insulin you will need, and if insulin of you need it at all.
How To Know When You’ll Need Insulin
Injecting insulin above and to the side of the belly button can result in more consistent results.
There’s no simple way to tell when a patient with type 2 would do best on insulin, says Richard Hellman, MD, former president of the American Association of Clinical Endocrinologists. But there are guidelines.
“In general if a patient has a hemoglobin A1C that is higher than the agreed upon goal and they are not on insulin, we recommend insulin therapy,” Dr. Hellman says. The American Diabetes Association recommends an A1C of 7% or below, and the American College of Endocrinology and the American Association of Clinical Endocrinologists recommend an A1C of 6.5% or below.
If you can’t lower your A1C with diet, exercise, or other medications, you may need insulin to do the job.
Exceptions to the insulin ruleThere are exceptions, of course. Someone who otherwise seems to be a good candidate for insulin may not be able to manage such a regimen if he or she has limited vision and dexterity and no family support. Good News About Today’s Improved Insulins
If you do need insulin in the short- or long-term, your doctor may prescribe one of four different types. These vary by how quickly or slowly they reach the bloodstream , the amount of time they work at maximum strength , and how long they continue to be effective .
According to the American Diabetes Association , your need for insulin is based on several factors.
Oral Medications Are Better Than Insulin
Oral diabetes medications can be great when it comes to lowering blood glucose levels. Many have been used for years and are very safe, such as .Still, they dont work for everyone. “For some people, insulin is the easiest and best because it always works, but some people respond to pills, and others dont,” says Dr. Crandall.Not all oral medications have a tried-and-true safety record. For example,
Avandia was restricted by the FDA because of research suggesting that it ups the risk of heart attack.
Producing Less Insulin Naturally Over Time
Research has shown that type 2 diabetes progresses as the ability of the body’s pancreatic beta cells to produce insulin dwindles over time. Your beta cells — the cells in the pancreas that produce insulin — slowly lose function. Experts believe that by the time you’re diagnosed with type 2 diabetes, you’ve already lost 50-80 percent of your beta cell function and perhaps the number of beta cells you had. And the loss continues over the years.
“About six years after being diagnosed, most people have about a quarter of their beta cell function left,” says Anthony McCall, M.D., Ph.D., endocrinologist and James M. Moss Professor in Diabetes at the University of Virginia School of Medicine. “With this minimal function, the need for injected insulin increases.”
Some experts say initiating insulin or other blood glucose-lowering medications early in the course of type 2 diabetes can lower blood glucose and even preserve some beta cell function.
Medicines For Type 2 Diabetes
Most people need medicine to control their type 2 diabetes.
Medicine helps keep your blood sugar level as normal as possible to prevent health problems. You may have to take it for the rest of your life.
Diabetes usually gets worse over time, so your medicine or dose may need to change.
Adjusting your diet and being active is usually necessary to keep your blood sugar level down.
Insulin And Weight Gain
When first starting insulin therapy, many people complain that they are eating and exercising the same amount as before but gaining weight. This occurs because with insulin, the body is able to use glucose that was previously wasted in the urine. Glucose that is not needed right away for energy is stored as fat. Studies have shown that weight gain may lead people, particularly women, to not follow their prescribed insulin regimen. This is a dangerous practice that can lead to sustained high blood glucose and a higher risk of long-term complications. Weight gain with insulin therapy is not inevitable, but avoiding it or reversing it generally requires eating fewer calories and/or exercising more.
People With Type 2 Dont Make Insulin
This isnt true. People with type 2 diabetes may actually produce higher-than-normal levels of insulin earlier in the course of the disease, a condition known as hyperinsulinemia. This happens because type 2 diabetes is caused by insulin resistance, a condition in which the body loses the ability to respond normally to the hormone. Taking insulin shots can help overcome insulin resistance, and they can take the place of naturally occurring insulin production, which does tend to dwindle over time.
What Other Injectable Medicines Treat Type 2 Diabetes
Besides insulin, other types of injected medicines are available. These medicines help keep your blood glucose level from going too high after you eat. They may make you feel less hungry and help you lose some weight. Other injectable medicines are not substitutes for insulin. Learn more about noninsulin injectable medicines.
Factors That Speed Insulin Absorption
Variation in insulin absorption can cause changes in blood glucose levels. Insulin absorption is increased by:
- injecting into an exercised area such as the thighs or arms
- high temperatures due to a hot shower, bath, hot water bottle, spa or sauna
- massaging the area around the injection site
- injecting into muscle this causes the insulin to be absorbed more quickly and could cause blood glucose levels to drop too low.
Travelling With Diabetes Medicines
If you’re going on holiday:
- pack extra medicine speak to your diabetes nurse about how much to take
- carry your medicine in your hand luggage just in case checked-in bags go missing or get damaged
- if you’re flying with a medicine you inject, get a letter from your GP that says you need it to treat diabetes
Page last reviewed: 18 August 2020 Next review due: 18 August 2023
Why Do Some People With Type 2 Diabetes Need To Take Insulin
Type 2 diabetes can progress with time, which means that it gets more difficult for a persons body to regulate glucose levels. The bodys many cells become less responsive to insulin , and the specific cells in the pancreas that produce insulin make less of it . This is not necessarily related to a persons diabetes management, and it is likely not possible to prevent.
For many people, adjusting lifestyle factors such as a reduced calorie diet and increased physical activity are key to keeping blood glucose levels stable and in a target range. Healthcare professionals may also recommend that people with type 2 diabetes take additional medications like , DPP-4 inhibitors, SGLT-2 inhibitors, or GLP-1 agonists to their treatment plan to improve glucose management, reduce A1C, lose weight, or support heart and kidney health.
Do You Need Insulin For Type 2 Diabetes
If you want to take insulin as part of your type 2 diabetes remedy, here’s a study how docs determine what dosage you’ll want. Long-acting insulin. This is on occasion called historical past insulin as it works for twenty-four hours or more. You usually take it once an afternoon at the equal time.
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How do you know if you need insulin? And if you do, what’s the best way to start? Before you and your health care provider make a decision, learn the As the body gradually produces less insulin, nearly everyone with type 2 diabetes needs one or more oral or injectable blood glucose-lowering.
If type 2 diabetes develops, your body?s ability to produce sufficient insulin may decrease and it Risk factors for type 2 diabetes. What to do if you’re at risk. Getting active. Join a community. Could affect employment if you drive for a living. The needles used for insulin injections are very slim and.
Not everyone who lives with type 2 diabetes needs to take insulin. Learn more about non-insulin treatment options for type 2 diabetes, including lifestyle changes and other medications. In some cases, people with type 2 diabetes need insulin injections to manage their blood sugar levels.
Your Doctor Might Prescribe Other Injectable Medication
Insulin isnt the only type of injectable medication used to treat type 2 diabetes. In some cases, your doctor might prescribe other injectable medications.
For example, medications such as GLP-1 receptor agonists and amylin analogues need to be injected. These types of medications both work to keep your blood glucose levels within a normal range, particularly after meals.
Depending on the specific medication, you might need to inject it daily or weekly. If your doctor prescribes an injectable medication, ask them when and how to take it. They can help you learn how to safely inject the medication and dispose of used needles.
Your Treatment Needs Can Change
Over time, your condition and treatment needs can change. If youve found it difficult to manage your blood sugar with lifestyle changes and other medications, your doctor might prescribe insulin. Following their recommended treatment plan can help you manage your condition and lower your risk of complications.
Myths About Insulin And Type 2 Diabetes
When you hear the word insulin, do you picture giant needles or pop culture portrayals of insulin users with low blood sugar ?Either way, most people think of insulin as a difficult, painful, or potentially scary medical treatment.The problem is that if you have type 2 diabetes, you need to know the real deal before you can make an informed choice about whether or not this potentially lifesaving therapy is right for you.Here, we take a look at the facts and fiction about insulin when it comes to treating type 2 diabetes.
Do You Have Insulin Resistance
How do you find out if youre insulin resistant? No one test will tell you, but if you have high blood sugar levels, high triglycerides , high LDL cholesterol, and low HDL cholesterol, your health care provider may determine you have insulin resistance.
Important note: Type 1 diabetes is different; its thought to be caused by an autoimmune reaction . People with type 1 diabetes dont make enough insulin and need to take it to survive.
Do I Need To Monitor My Blood Sugar Level
Yes. Monitoring and controlling your blood sugar is key to preventing the complications of diabetes. If you dont already monitor your blood sugar level, you will need to learn how. Checking your blood sugar involves pricking your finger to get a small drop of blood that you put on a test strip. You can read the results yourself or insert the strip into a machine called an electronic glucose meter. The results will tell you whether your blood sugar is in a healthy range. Your doctor will give you additional information about monitoring your blood sugar.
When To Start Insulin
Insulin is usually started when oral medicines and lifestyle changes have failed to lower a persons level to less than 7%. However, a recent consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes suggested that insulin is a reasonable choice if a persons HbA1c level remains above 7% while he is taking metformin alone.
Learn More About Treatment Approaches>>
Large studies of people with Type 2 diabetes have shown that only about 30% of people taking two oral medicines have an HbA1c level of less than 7% after three years. Insulin is usually recommended as the initial therapy for diabetes if a persons HbA1c level at diagnosis is greater than 10% or if someones fasting blood glucose level is consistently above 250 mg/dl.
Studies have shown that many doctors wait until someones HbA1c level is higher than 9% to start insulin therapy, which often results in months or years of high blood glucose and an increased risk of developing complications later on. One unfortunate reality is that many busy medical practices are not set up to address the needs of people who take insulin. Starting insulin requires education and easy access to health-care providers who are knowledgeable about insulin therapy, including diabetes nurse educators, pharmacists, and doctors.
How To Start Insulin
When first prescribing insulin for a person with Type 2 diabetes, doctors generally start with a single daily injection of long-acting insulin. Determining what dose of insulin to begin with can be done in different ways. One option is to choose a starting dose based on a persons weight. Eventually, many people with Type 2 diabetes will require 12 units of insulin for every kilogram of body weight; that is, an 80-kilogram person will require at least 80 units of insulin each day. To start, however, your doctor may begin by prescribing 0.15 units of insulin per kilogram. For an 80-kilogram person, this would be 12 units.
Another option is simply to start with 10 units of insulin, a large enough dose to decrease blood glucose levels for most people but not so large that it is likely to cause hypoglycemia. The dose can then be increased every 37 days based on fasting blood glucose values. A morning blood glucose reading of 80100 mg/dl is ideal, so with numbers that fall in this range, you would not make any changes. If your morning blood glucose readings were under 80 mg/dl, you would decrease your insulin dose by 2 units. Most people, however, will need to increase their dose of insulin above the initial level. It is generally safe to adjust ones basal insulin according to this scale.
Which Is More Accurate The Freestyle Libre2 Or The Dexcom G6
According to an article from the DiabetesMine, there is little difference in accuracy between the Libre2 and the Dexcom G6®.
Clinical data for the Dexcom G6® shows it has a MARD of 9 percent while the FreeStyle® Libre 2 has a 9.3 percent total MARD score . In other words, the Dexcom G6 is slightly more accurate, especially in children.
Which Is Better The Libre2 Or The Dexcom G6
Users seem to be torn on which system is the best. There are many reasons to like the Dexcom G6® and many reasons to like the Libre2. Two things seemed to stick out, however.
If you are concerned about cost, the Libre2 seems to be the clear winner. It has a lower price point, and many users find it to be reliable enough for their needs.
If you want accuracy and more detailed alerts, then Dexcom G6® would be more beneficial for you.
Lauren Plunkett at LP Nutrition Consulting summed it up the best. If you are active and may have sudden changes in blood sugar, the Dexcom G6® may be your best option. If you are looking for a basic system that shows blood sugar deviations the Libre2 offers affordable and efficient monitoring.
As with all diabetes products, educate yourself. Know the features that you require in your device and discuss your options with your diabetes team. Not everyone is the same and therefore not every diabetes device will be right for every person with diabetes.
How Insulin Medicine Is Made
Insulin is made in different ways. You and your healthcare team will discuss which insulin you can take.
- Human insulin this is synthetic and made in a laboratory to be like insulin made in the body.
- Analogue insulin the insulin molecule is like a string of beads. Scientists have managed to alter the position of some of these beads to create genetically engineered insulin known as analogues.
- Animal insulin This isnt used much anymore, but some people find that insulin from animals works best for them. It is usually from a cow or pig.
What About Your Pills
Should you/will you stay on your diabetes pills when you start taking insulin?
Experts and health care providers have varying opinions. Many agree that you should stay on the pills that treat insulin resistance, such as metformin. Some health care providers suggest you stop taking pills that help your pancreas produce more insulin, such as sulfonylureas or meglitinides, while others don’t. If you don’t see improvement in blood sugar control, ask your health care provider questions and talk about options.
How To Reverse Insulin Resistance
If you have insulin resistance, you want to become the oppositemore insulin sensitive .
Physical activity makes you more sensitive to insulin, one reason why its a cornerstone of diabetes management . Dont wait until youre diagnosed with diabetes to start moving more. The earlier you take action , the better off youll be.
Weight loss is important too, as is avoiding high blood sugar, reducing stress, and getting enough sleep .
These lifestyle changes really work. Talk with your health care provider about how to get started.
What Oral Medicines Treat Type 2 Diabetes
You may need medicines along with healthy eating and physical activity habits to manage your type 2 diabetes. You can take many diabetes medicines by mouth. These medicines are called oral medicines.
Most people with type 2 diabetes start medical treatment with pills. Metformin also comes as a liquid. Metformin lowers the amount of glucose that your liver makes and helps your body use insulin better. This drug may help you lose a small amount of weight.
Other oral medicines act in different ways to lower blood glucose levels. You may need to add another diabetes medicine after a while or use a combination treatment. Combining two or three kinds of diabetes medicines can lower blood glucose levels more than taking just one.
Read about different kinds of from the Food and Drug Administration .
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.
What Happens If You Avoid Taking Your Insulin
If you have type 1 diabetes, taking insulin is essential and you cannot live without it. If you avoid taking it, your blood sugar levels can become too high and you risk developing diabetic ketoacidosis . If left untreated, DKA could be life-threatening. Thats why its important to make sure you take your insulin.
If you have type 2 diabetes and use insulin to treat your condition, you should continue to take it as prescribed. If you avoid taking it, your blood sugar levels could become too high and you may become ill. Please speak to your healthcare professional if you have any questions or concerns about taking your insulin.
Insulin is a treatment that helps manage blood sugars, so this also reduces the risk of serious long-term complications as well a shorter-term consequences. Its still important to keep going to your appointments and manage your condition with healthy lifestyle choices. Staying active and eating a healthy diet will reduce the risk of complications from your diabetes, but insulin is also an important part of your treatment.
Benefits Dependent On Age At Treatment Initiation And Side Effects
For their study, led by Sandeep Vijan, professor of internal medicine at the University of Michigan Medical School, the team assessed 5,102 patients in the UK with type 2 diabetes who managed their condition through the use of insulin pills or injections.
Over a 20-year follow-up, the researchers looked at how the treatments affected patients overall quality of life and whether they were effective in reducing their risk of diabetes complications.
They then compared the reduced risk of such complications with the burden of using diabetes medications and the side effects associated with them.
According to the researchers, they found that the benefits of insulin therapy for patients with type 2 diabetes are very much dependent on their age at treatment initiation and the potential side effects, rather than their blood sugar levels.
For example, they estimate that a person with type 2 diabetes who begins insulin therapy at age 45 and lowers their hemoglobin A1c levels by 1% may experience an extra 10 months of healthy life.
But for a patient who starts treatment for type 2 diabetes at age 75, they estimate the therapy may only gain them an additional 3 weeks of healthy life. The researchers say this prompts the question is 10-15 years of pills or injections with possible side effects worth it?
Prof. Yudkin comments: