Insulin Treatment

People who have type 1 diabetes must be treated with insulin, have the lifelong task of trying to achieve near normal blood glucose values to reduce the chances of developing the disabling complications of diabetes. This is done by injecting insulin under the skin, and requires from 2 to multiple injections per day. Blood glucose measurements are made but pricking the skin and measuring the value using a meter, and insulin requirements have to be estimated daily from patterns of food intake, exercise, and these blood glucose results. Many people with type 2 diabetes also need insulin treatment when tablets do not control blood glucose adequately.
Adjusting Your Insulin Dose
on a multiple injection regimen
Although people’s insulin requirements are variable, there are some common principals of how to adjust your insulin dose. The target is for you to keep your blood sugar in the range from 5 to 7 before meals and below 10 two hours after a meal. These are the following rules, which you need to think about:
If your blood sugar is high the reasons may be because:
1. You have had more food than usual or more foods containing sugars than usual.
2. You have done less physical exercise than usual.
3. You are having an insufficient dose of insulin.
4. You may have an illness, such as a cold or flu, or another infection and (lastly, occasionally your insulin may be out of date or faulty).
5. If you are female, you may be in the pre-menstrual part of your cycle.
Conversely, if your blood sugar is low, it may be because:
1. You have had less food than usual.
2. You have done more exercise than usual.
3. You have had more insulin than you need.
4. You have drunk too much alcohol.
When you notice your blood sugars are not within the target range, you need to think through the above possibilities and work out which one you think it is.
Advice on
You need to anticipate the effect of exercise. If you know you are going to have a busy day at work, or going to do a period of strenuous exercise later on in the day, reduce your quick acting insulin by half in the period prior to the exercise For example, if you are going to busy at work in the morning with a lot of lifting, or you are going to go on a walk, decrease your breakfast insulin to half the normal dose. This will stop you going hypo during the exercise.

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