Even before you were diagnosed with Type 2 diabetes, you knew that people with Type 2 diabetes may need to use insulin. Since your diagnosis, using insulin for Type 2 diabetes has become a personal issue. You may have a lot of questions about insulin treatment for Type 2 diabetes, and we’ll strive to give you the information you need right here. If this still leaves you with questions, do consult your doctor.

The Role of Insulin in the Body

Insulin is secreted by the pancreas in response to rising blood glucose levels, for example, after eating a meal. Insulin is a messenger that tells the cells in your body to absorb glucose from the bloodstream and use it as a source of energy. If there’s still excess glucose, insulin “tells”  your body to store it in the form of glycogen in the liver, muscles and fat.

Insulin is, therefore, a regulator that prevents your blood glucose levels from rising to dangerous levels where it can cause damage to the body or result in diabetic ketoacidosis, a life-threatening condition where people can become very ill if blood glucose levels are very high for a prolonged period of time.

When you are diagnosed as having Type 2 diabetes, insulin treatment makes up for the fact that your body isn’t responding to insulin as it should. Extra insulin helps to get the message across.

Goals of Insulin Therapy in Type 2 Diabetes

If you’ve just been diagnosed with Type 2 diabetes, you may not yet need insulin therapy. However, the longer you live with Type 2 diabetes, the more likely you are to need extra insulin. However, if you do find yourself needing insulin, don’t see it as a “failure.” Many people with Type 2 diabetes will eventually need to use insulin, and the primary goal of insulin therapy is to keep your blood glucose levels within safe limits and protect your body from complications.
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Types of Insulin

There are several types of insulin, and they’re categorised according to how long it takes for them to work, and the length of time for which they keep on working. The types that act faster won’t act for as long, and the ones that take effect more slowly continue to work for longer.

Rapid action insulin has an effect within 15 minutes, is at its most effective after an hour, and stops working after 2 to 4 hours.

Regular insulin starts to work within 30 minutes, reaches its peak after 2 to 4 hours, and continues to work for 3 to 6 hours.

Intermediate-acting insulin takes 2 to 4 hours to start working, peaks after 4 to 12 hours, and continues to be effective for 12 to 18 hours.

Long-acting insulin takes longer to have an effect and continues to work at a relatively steady rate for up to 24 hours.

So, what’s the best insulin for Type 2 diabetes? It depends on your specific circumstances. Doctors may start with a once daily “basal” insulin in the form of an intermediate-acting or long-acting type of insulin. When you combine oral medications with insulin, you can usually take less insulin than you would if you were using nothing but insulin. It’s important to work with your doctors to see how you respond to treatment and to optimise your insulin dose. Since this changes over time, it’s an ongoing process.

Insulin Delivery Options

Insulin must be delivered directly into the bloodstream, and there are several ways to achieve this. The standard syringe is the best-known option but a lot of people living with diabetes prefer an insulin pen. It looks very like a regular pen and helps with getting the dose just right. The pen contains an insulin cartridge and works with screw-on disposable needles. Instead of drawing the insulin from a vial as you would with a regular syringe, you simply dial in the correct dose.

There are also two less commonly-use delivery methods. Insulin pumps are more commonly used for short-acting insulin and are attached to a catheter implanted in the abdomen. Very rarely, jet injections are used for people who can't tolerate needles. They use a jet of air to force the insulin through the skin and are likely to cause some bruising in the process. There are currently trials going on for insulin tablets, and it may be possible that in the future, insulin treatment might not involve daily injections.

Injecting and Storing Insulin

Your doctor should show you how to inject insulin. Always follow instructions carefully.  The procedure for injecting insulin will vary according to the delivery method, but a few factors remain constant. Always check expiry dates, and be absolutely sure that you have the right type of insulin. Examine the insulin. If you see clumping inside the vial, you will have to throw it away and get fresh insulin.

You can store insulin in the refrigerator to help keep it fresh, but it should be at room temperature when you inject it. Once you’ve started a vial, it will keep at room temperature for up to 28 days. Always wash your hands before preparing an injection, use alcohol wipes to disinfect the injection site, and never reuse needles - even a puncture wound as small as a needle tip can get infected if you don’t practice good hygiene.

Insulin Side Effects

When you are using insulin for Type 2 diabetes, side effects may occur. The most common possible side effect of insulin is hypoglycemia - blood sugar levels that fall below the targeted level. If you find that you’re experiencing shakiness, sweats and chills, mood disturbances, dizziness, rapid heartbeat, or other unusual symptoms, your insulin dose may need adjustment.  

If you notice bumps developing at injection sites, you’re experiencing lipohypertrophy.  It happens because insulin can make fat cells near injection sites grow in size.  You can get a device that helps to reduce lumps, but people who use insulin develop these over time. Never inject insulin into one of these bumps as it will not absorb properly. Change your injection site frequently in accordance with advice from medical personnel. This will also help to prevent scarring and skin irritation.

It’s very rare, but some people experience allergic reactions when using insulin. If you notice swelling at the injection site, or develop an itchy rash, contact your doctor for advice. If you are having difficulty breathing, get help urgently.

If you are getting too much insulin, you might gain weight. Don’t adjust your dose without consulting your doctor as it can be risky. Your doctor can help you to investigate whether your weight gain is attributable to insulin or whether there is some other reason for it.

What Happens if You Avoid Using Insulin

If your medical team has identified a need for you to use insulin, keep taking it. Simply discontinuing it will make you very unwell. Your high blood sugar levels can cause permanent damage to your body, and complications like ketoacidosis can be fatal.  It is possible to reduce your need for insulin through a healthy diet and exercise, and you should certainly try doing so, but always do this in consultation with your doctors.

Need Help With That Healthy Lifestyle?

In Type 2 diabetes, insulin injections can safeguard your body from the dangerous effects of high glucose levels in your blood. A healthy lifestyle can help you to reduce your need for insulin, but changing our habits is never easy. At Blueberry Life, we not only help people with chronic conditions to get cost-effective life insurance, we also offer support to help you with your healthy lifestyle choices. Who doesn’t need a bit of extra motivation from time to time? Need something more? Our rewards program recognises your efforts to live a healthy life. We know it’s possible, and we’d like to help you live the healthy and fulfilling life you want. Let’s work on this together! Join us today. It’s easier than you may have thought!

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Reviewed by Dr. Kingshuk Pal