Diabetes occurs when your pancreas does not make enough insulin, called Type I Diabetes Mellitus, or your body cannot use the insulin correctly, called Type II Diabetes Mellitus. Insulin is a hormone made by your pancreas that, among other jobs, lets you turn blood sugar into energy. To understand why the insulin hormone is so important for your health, consider what it does. The food you eat is changed into sugar, which is the fuel that runs your body. People without diabetes make insulin that “unlocks” the cells so sugar can move from the bloodstream into the cells to provide energy. People with diabetes do not have enough insulin, or are resistant to insulin, so sugars stay in the bloodstream. As a result, the cells are starved because the sugar cannot get in. Because blood touches every part of your body, high levels of blood sugar can damage your vision, nerves, heart, and kidneys. In addition to sugar, insulin is important for proper use of proteins and fats by your cells.

Preventing Diabetes-Related Problems

Taking insulin or diabetes pills to keep your blood sugars from getting too high can slow down and even prevent serious diabetes-related problems. A major study of people with diabetes found that those who maintained their optimal blood sugar reduced their risk of a serious diabetes-related eye disease and blindness by 76 per cent. People who already had some damage from diabetes slowed the progress of their eye disease by 54 per cent. People who used their medicines to keep their blood sugars under tight control reduced their risk of diabetic kidney disease by 50 per cent. Those who already had diabetic kidney disease slowed its progression by 50 per cent. Using medication to control blood sugars reduced the risk of nerve damage that causes many diabetic people to have to have their feet and legs amputated by 60 per cent. Your healthcare provider will explain how to take your medicine to maintain your optimal blood sugar.

Diabetes Pills

People with Type II diabetes may take diabetes pills that work in various ways to control blood sugar. Some pills push the pancreas to make more insulin. Others slow down the amount of sugar released by your liver. Some medications prevent the body from absorbing the sugars from food. Your healthcare provider may prescribe one or more kinds of diabetes pills, or may ask you to take one pill that combines the effects of several different types.

Insulin Facts

Many people with Type II Diabetes, and all with Type I Diabetes, require insulin. Insulin must be injected under the skin with a tiny needle. It is destroyed if taken orally or swallowed. How insulin works depends on many factors:

  • Amount: the more insulin you take the lower your blood sugar will be.
  • Characteristics: each type of insulin has three characteristics that describe it:
    • The onset, which is when the insulin starts to work.
    • The peak, which is when it works hardest.
    • The duration, which is how long it works.
  • Types:
    • Long acting insulin has its onset in 4 to 8 hours and peaks 12 to 18 hours after you take it. Its duration is about 24 to 28 hours.
    • Intermediate acting insulin has its onset in 1 to 3 hours and peaks 6 to 12 hours after you take it. Its duration is from 18 to 24 hours.
    • Short acting insulin, commonly called regular insulin, has its onset in half an hour and peaks 2 to 4 hours after taking it. Its duration is 6 to 8 hours.
    • Very short acting insulin has its onset in 10 to 15 minutes and peaks between a half hour and one hour and a half after you take it. Its duration is 3 to 5 hours.
  • Injection location: insulin can be injected into several places on your body. Insulin injected near your stomach works fastest, into your thigh slowest, and into your arm at medium speed. It is important to be consistent in choosing your injection places. Your healthcare provider or diabetes educator can teach the right way to take insulin and where to inject it.
  • Body’s response: everybody responds differently to insulin. You and your healthcare provider need to work together to find the insulin plan that will work for you.
  • Activity level: the more active you are, the more energy you use. The more energy you use, the more sugar you require. Your insulin may need to be adjusted when you change your activity level such as when you exercise.
  • Diet: how much you eat, what type of food you eat, and when you eat all affect the amount of insulin your body requires. A dietician can customize a meal plan that fits your needs and lifestyle.
  • Surgery and illness: talk to your healthcare provider about a plan when you are sick or need an operation.
  • Stress: whether physical or emotional, stress can affect your insulin needs.

The DOs

  • Store your unopened insulin in the refrigerator. Insulin kept at room temperature is good for a month.
  • Write down your healthcare provider’s directions on how to take your insulin.
  • Keep at least one extra bottle of each type of insulin you use in the refrigerator.
  • Bring a prescription of your insulin when you travel.

The DON'Ts

  • Do not leave the insulin you are using in a very hot or very cold place. This will ruin it.
  • Do not use insulin that has expired or use insulin that looks cloudy or crystallized.
  • Do not freeze insulin.

Things to Remember

  • The best way to know if your diabetes pills or insulin are working to keep blood sugar under control is to test your blood sugar regularly and record the results in a logbook. Your healthcare provider will tell you how often to test your blood sugar.

What We Have Learned

  1. Diabetes pills can always be a substitute for insulin.
    True or False
    The Answer is False
  2. Insulin is always taken by giving a shot.
    True or False
    The Answer is True
  3. The only way to know how your insulin or diabetes pills are affecting your blood sugar is to True or False
    The Answer is True

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