When your doctor tells you that you have Type 2 Diabetes Mellitus, you may be told to take insulin. But in reality, not everyone with Type 2 Diabetes needs insulin. But if you have to take insulin, it is very important for your health to determine the right dose. Sometimes you may have to adjust this dose yourself as your lifestyle changes. So, let's talk about this simply.
How is insulin treatment planned?
The key here is to keep your blood sugar levels within a safe range. This may require you to use one type of insulin or two. Doctors usually start with one type first.
1. Long-acting insulin
Another name for this is basal insulin . Simply put, once you inject it, it works in your body for about 24 hours, sometimes longer. It's like controlling your blood sugar levels in the background. It's usually taken once a day, but it's important to take it at the same time every day.
How do you determine the dosage?
There are several types of this type of insulin, and the dosages for each may vary.
- Typical starting dose: Most people start with about 10 units per day.
- Weight-based dosing: Sometimes your doctor will decide the dosage based on your body weight. For example, your body weight may be calculated as 0.2 units of insulin per 1 kilogram (2.2 pounds).
The initial dose may be lower than you need, but it's a good start. Then, your doctor will gradually increase your dose by two to four units every three days until your fasting blood sugar is at your target level (usually between 80-130 mg/dL ). Choosing the right type of insulin for you will depend on many factors, including your weight, blood sugar levels, whether you have other medical conditions, the cost of insulin, and your preferences.
2. Meal-specific insulin (Short- or Rapid-acting Insulin)
Your doctor may also call this bolus insulin or prandial insulin . These are given before a main meal to help your body control the amount of carbohydrates in the food you eat. This type of insulin is added when the all-day insulin mentioned above is not enough.
How do you determine the dosage?
The dosage depends on several factors: your target blood sugar level, the amount of carbohydrates in the meal you eat, and your level of activity.
- Fixed dose:Typically, you can start with 4-6 units and increase by 2-3 units every 3 days until your sugar levels are under control.
- Carb Counting: This is a slightly more advanced method. Here, you calculate the insulin dose based on the amount of carbohydrates you eat.
- Accidentally taking an overdose .
- Mixing short-acting and long-acting insulin types.
- Eating a low-carbohydrate meal and taking more insulin for it.
- Forgetting to eat after taking insulin.
- Exercising more than usual and not reducing your insulin dose to compensate.
- The type and dose of insulin is specific to you. Always follow your doctor's instructions. Don't compare your dose to other people's.
- Understand the difference between long-acting and short-acting insulin.
- Be aware of the symptoms of low blood sugar (hypoglycemia). Don't panic and know exactly what to do in such a situation.
- Do not rely on unapproved, untrusted phone applications (apps) to calculate insulin doses.
- Check your blood sugar levels regularly. Talk openly with your doctor about any changes and any concerns you may have.
Think of it this way: You eat a slice of pizza, and it has 60 grams of carbohydrates. Typically, 1 unit of rapid-acting insulin "covers" about 10-15 grams of carbohydrates. Let's say 10 grams. Then you need about 6 units of insulin for that slice of pizza.
This insulin-to-carb ratio varies from person to person. It may even change at different times of the day. Therefore, it is important to talk to your doctor to find the formula that is right for you.
What happens if the insulin dose is increased?
If you take too much insulin, your blood sugar level can suddenly drop dangerously low. This is called hypoglycemia . This is a serious condition that can be life-threatening.
What causes increased insulin?
| Common symptoms of low blood sugar (Hypoglycemia) | |
|---|---|
| Anxiety | Headache |
| Dizziness | Nausea |
| Fast heartbeat | Shakiness |
| Sweaty or clammy skin | Extreme hunger |
The important thing is that these symptoms can vary from person to person, so pay attention to how your body feels.
What to do immediately if your blood sugar drops
The only way to know for sure if your sugar is low is to measure your sugar level right away with a glucometer.
1. If your blood sugar level is below 70 mg/dL , eat something sugary as soon as possible. For example, eat a glucose tablet, half a glass of sugar-free fruit juice, or a tablespoon of honey. This will provide about 15 grams of fast-acting carbohydrates.
2. Wait 15 minutes.
3. Check your blood sugar level again.
4. If it is still low (above 70 mg/dL), eat something sugary again . Once your sugar level returns to normal, it is best to eat a small snack (e.g., a slice of bread).
If this happens frequently, or if it becomes so severe that you lose consciousness, immediately have someone take you to the nearest Emergency Treatment Unit (ETU) .
Can apps be used for this task?
There are many apps that claim to help you figure out your insulin-to-carb ratio or calculate your insulin dose. But a 2015 study found that most of these don't work properly. It's very dangerous. If you're prescribed the wrong dose, it could even be life-threatening.
Therefore, if you must use an app, only use a trusted app recommended by your doctor or diabetes clinic.
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