Type II Diabetes and Insulin - All You Need To Know.

It is well known that diabetes can lead to serious health problems. These problems are made worse in those who do not adequately control their blood sugar levels. When one is diagnosed with diabetes they are usually started on various tablet medications to control sugar levels, however when these tablets are no longer effective at controlling these levels insulin may need to be taken.

What is insulin?
Insulin is a hormone that works to keep the level of sugar in your blood under control. In people who do not have diabetes the body makes a sufficient level of insulin to control the sugar levels. However if you have type 2 diabetes, your body doesn’t make enough insulin and the small amount of insulin it does make fails to work properly. This is a problem as too much sugar builds up in your bloodstream, which can make you sick. The insulin that is made in the laboratory is almost identical to the insulin that your body makes when you are healthy. There is no difference between how the insulin in your body works versus the insulin that is made in the laboratory. You must inject the insulin into your self though because if insulin were taken as a tablet the digestive juices in your stomach would destroy it. Some people are worried about the idea of having to give themselves an injection. But in fact the devices that are created to administer the insulin make injecting an easy and almost pain free experience. People who take insulin daily find that they get used to the idea of an injection and it becomes an easy part of their daily routine.

Why might I need to take insulin?
Almost everyone who is diagnosed with type 2 diabetes is started on tablets in order to control their blood sugar levels. Tablets of this kind encourage the body to make more use of the insulin it is still making or helps the body to make more insulin. For some people the tablets are enough and they are able to go through the rest of their lives just taking these pills. However many diabetics find that their bodies produce such a small amount of insulin that the tablets just simply are not enough. These are the people who will need to take insulin on daily basis. When the levels of blood sugar are too high you can get some nasty side effects such as you may get really tired and thirsty. Also if these sugar levels are high for a long period of time they can cause serious damage to areas of your body such as your blood vessels, kidneys, eyes and the nerves in your feet. Your doctor will measure how high your blood sugar levels have been over a period of time using a blood test called the haemaglobin A1c test (also known as HbA1c). The results of this test will inform the doctor of how well you blood sugar has been controlled over the last few months and will allow them to make a decision on whether or not you need to start taking insulin.

How can it help?
Having insulin injections can help bring your blood sugar levels back under control. As a result of good sugar control you should no longer get those horrible symptoms like feeling tired and thirsty. In addition with lower blood sugar levels it is much less likely that you will damage your blood vessels and get other health problems. People who take insulin because their diabetes is not well controlled usually find that the HbA1c blood test is usually a couple points lower after about 4 months. This is indicative that their blood sugar is better controlled with insulin. If you have just been diagnosed with diabetes it is unlikely that you will be started on insulin as the tablets are likely to work for you and insulin is in many cases the final line of treatment. Therefore by keeping you sugar under control with the tablets and other health measures you are less likely to require early insulin treatment, if you will need it at all.

Can it be harmful?
If you take insulin injections instead of tablets, there is a higher chance that you will get symptoms of low blood sugar (hypoglycemia) and you may in fact put on some weight. It seems that the biggest problem with taking insulin is that it takes some time to get a good balance between the dose of insulin dose and the level of activity that you partake in. If you take too much insulin, you could get low blood sugar (hypoglycaemia). But if you don’t take enough insulin, your blood sugar goes too high. This is called hyperglycaemia. If you are taking insulin it is vital that you check your blood sugar levels regularly so that you can be sure they are not peaking to high or too low at any point throughout the day. Before you start taking insulin, your doctor or nurse will explain how to recognize the signs of very low blood sugar, and what to do about it so that you will be well educated before you go home. Some people call having very low blood sugar having a hypo (from the word “hypoglycaemia”). The symptoms of low blood pressure like this are drowsiness, dizziness and confusion; it is even possible that you may lose consciousness. For obvious reasons this is very dangerous, however if you are able to recognize the early warning signs then you can reverse or prevent this episode by simply taking some glucose pills or by having a sugar filled drink.

How and when do I take insulin?
The type of insulin you take will depend on how your body responds to insulin and how you want to take it. Either your doctor or nurse who specializes in diabetes will help you to work out the best insulin schedule for you. You have to be patient though as it takes some time to work out a dosing schedule that will fit in with your lifestyle. Because everyone leads such different lives it is obvious that different people will need different dosing schedules. It is also important to realize that that the amount of insulin that you require changes depending on how much you eat and how much exercise you do or do not do. So you will require more insulin on Thanksgiving Day than you would on any other normal day of the week. Some people find that the best way to manage their insulin requirements is by having an insulin injection just before they eat, and then by having a long lasting insulin dose at night. You will have to adjust your dose of insulin if you plan to eat, or exercise, more or less than usual. If you are sick and have an infection your body will be using more energy to fight off the infection and so will need to alter your insulin schedule. The same is also true when undergoing hormone changes from puberty or pregnancy and you will need to be extra careful during these times. It is important to visit your doctor or diabetes nurse if you find it hard to control your own blood sugar levels.

There are a few different places on your body that you are able to inject insulin into, but there are a few important things to remember:

• Insulin injected in your abdomen works fastest.
• Insulin injected into your thigh works more slowly.
• Insulin injected into your arm works at medium speed.

Knowing these things are important when you are injecting insulin daily and thus it is important you ask your doctor if you have any questions regarding your insulin schedule or regime.

Testing your blood glucose
If you take insulin, you need to test your blood sugar regularly to make sure it isn’t getting too high or too low. There are special units designed to help you do this quickly and easily. Usually you take some of your blood via a finger prick test. This is done via a device with a button on the top and when you push this button, a very small needle comes out and pricks your finger to give the right amount of blood. When you have a drop of blood on your finger, you touch the drop to a test strip on the meter. The machine then analysis the blood and tells you just how much sugar is in it. The amount of tests that you require per day is variable and you doctor will help you decide how many you require and when. Some people only require only one test a day whereas others test prior to insulin administration up to three or four times per day. You need to adjust your insulin dose or your activities, based on your test results. Although some people find it hard in the beginning they quickly get used to it and blood sugar testing and insulin administration quickly becomes a regular part of their daily lives.

Driving and insulin
You need to be careful about your blood sugar level when you’re driving. If it drops too low when you’re at the wheel, you could have a hypo and black out. It is vital to check your blood sugar level before you get into the car and ensure that you have some sugary drinks or snacks in the car. If you are driving and begin to recognize that you are going to have a hypo attack you must pull over and have a drink or eat some sugary treats. It is then important to recheck your blood before driving again.

What are the alternatives?
If you are not on insulin and are a type 2 diabetic then it is important to watch you diet carefully and continue to take diabetes tablets. Some people do find that diet restriction and tablets are enough to keep their sugar levels under control. However if your blood sugar is not well controlled with tablets you risk getting health problems from diabetes. If you have talked to your doctor and they believe that you should be on insulin make sure you take the time to discuss this with them. Your doctor will also make sure that you know how to inject and test your blood sugar levels. It is vital that you feel confident and that have adequate support to start insulin, if you feel lost or are worried ensure you discuss this with your doctor.

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