Insulin 101

Insulin Demystified!

Insulin Demystified!

The capacity to learn is a gift; the ability to learn is a skill; the willingness to learn is a choice.
— Brian Herbert

Disclaimer: This post is for informational purposes only. Please consult with doctor and/or pharmacist regarding your insulin dosage or if insulin is right for you.

It seems like a week does not go by where someone asks me about insulin. For many people with diabetes and health professionals insulin can be confusing. What is insulin? Why do some people with diabetes need insulin and other don't? What is the difference between basal insulin and bolus insulin? I hope this post will answer your questions.

I could give you the formal encyclopedia definition of insulin but I will keep it simple by defining insulin as a hormone produced by the pancreas to help your body properly use glucose(sugar).  EVERYONE needs insulin to survive! 

The next question I am usually asked is what is the difference between people with type I and type II diabetes regarding insulin? People with type I diabetes make no insulin and need take insulin to survive. PERIOD. About 5% of people with diabetes have type I diabetes. These individuals also need two types of insulin to properly manage their diabetes; basal and bolus insulin. We will discuss these types later. 

95% of people with diabetes have type II diabetes. These individuals make insulin but they do not make enough for their body to properly use  or they are "insulin resistant". A simple technique to make the body more sensitive to insulin is to lose weight for people with type II diabetes. 

There are two main types of insulin; basal and bolus insulin. First let's talk about basal insulin.

Your body is producing glucose(sugar) 24 hours a day. The difference between someone with or without diabetes is how much insulin their body is producing to keep their blood sugar(glucose) stable. People without diabetes are producing the same amount of insulin as glucose(sugar). People with type I diabetes is producing no insulin so their blood sugar stays high and people with type II diabetes are somewhere in between. 

Basal insulin is used to keep your blood sugar(glucose) stable when you are sleeping or between meals. There are two types of insulin doctors prescribe; immediate acting and long acting.

Humulin N or Novolin N AKA NPH are considered intermediate acting basal insulin.  This insulin is usually injected twice daily.  Lantus, Levemir and Toujeo are the brand names for long acting insulin. Long acting insulin come in generic form so do not panic if you don't see these brand names on your prescription. Long acting insulin is usually injected once a day. Talk to your doctor and pharmacist to find the right dose.

When you eat a meal with carbohydrates your body needs extra insulin to process the glucose(sugar) properly. By the way, you need carbohydrates to survive so totally avoiding carbohydrates is not advised. As always, people without diabetes produce enough insulin to digest glucose(sugar), people with type I diabetes have no insulin to metabolize sugar(glucose) and people with type II diabetes are somewhere in between.  Bolus insulin is required at meal times to keep people with type I diabetes under control. 

Short acting and rapid acting are two types of bolus insulin doctors prescribe. Humulin, Novolin and Regular Insulin are typically the names used to describe short acting insulin. Short acting insulin usually starts working about 15 to 30 minutes after you inject it. Novolog, Humalog and Apridra are the brand names for rapid acting insulin. Rapid acting insulin works quickly after you inject it. How quickly? Usually five minutes after you take it so make sure you ready to eat as soon as you take it. Again, talk to your doctor and/or pharmacist. 

Some of you are probably asking, "Why have the not invented insulin with basal and bolus insulin already available?" Well there is such an insulin. 70/30, 75/25 and 50/50 insulin are premixed basal and bolus insulin. Premixed insulin is usually injected twice daily before breakfast and dinner. Many doctors love to prescribed this insulin to people with type II diabetes with poor glucose(sugar) control to help them manage their diabetes. For some reason this mix does not work well with people with type I. Let me repeat again, "TALK TO YOUR DOCTOR AND/OR PHARMACIST!"

Now, the final question is how soon do I start insulin if I have diabetes?  If you are diagnosed with type I diabetes the answer is NOW. People with type I diabetes will not survive without BOTH basal and bolus insulin. If you have type II diabetes it may be a different story. Most people, except for maybe recreational drug users, are not happy about injecting themselves  with insulin. However, for the 5% of people with type I diabetes and individuals who are not meeting their targets with type II diabetes insulin is a life saver.

If you have any more questions about insulin please feel free to leave comments below. Understand you are probably not the only person with this question and your input could help others.