T HE I NS AND O UTS OF I NSULIN Mary Beth Wald, RN,BSN,CDE

W HAT HAPPENS IN MY BODY ? When we eat, the food gets changed into glucose, a type of sugar. Glucose travels in the blood to all the cells in your body for energy Insulin moves or transports the glucose from the blood to the cells

W HAT IS INSULIN ? Insulin is a hormone made by your pancreas

W HY DO I NEED INSULIN ? Insulin helps control the level of blood glucose in the body When you have diabetes: Your body does not make any insulin Your body does not make enough insulin Your body prevents the insulin you do produce from working properly

T HE HISTORY OF INSULIN Insulin was discovered in 1921 by a group of Canadian scientists and was made from animal pancreas Human insulins we use today were first genetically made in the early 1980’s Newer insulins called analogs have been in use since 1996

H OW INSULIN WORKS Onset - amount of time after injection that the insulin enters the blood and begins to lower the blood sugar Peak - time period when the insulin is working hardest to lower the blood sugar Duration - the amount of time insulin has an effect on the blood sugar

T YPES OF INSULIN REGULAR insulin short-acting insulin starts working in 30 minutes works the hardest 2 1/2 to 5 hours lasts for 8 hours usually taken twice a day

T YPES OF INSULIN NPH insulin intermediate-acting insulin starts working in 1 to 2 hours works the hardest 4 to 8 hours lasts 4 to 12 hours usually taken 1 to 2 times a day

T YPES OF INSULIN 70/30 insulin 70% NPH insulin and 30% Regular insulin premixed insulin starts working in 30 minutes usually taken twice a day

T YPES OF INSULIN HUMALOG, NOVOLOG, APIDRA rapid-acting analog insulin starts working in 10 to 20 minutes works the hardest in 1 to 3 hours lasts 4 to 5 hours taken before meals

T YPES OF INSULIN LANTUS, LEVEMIR long-acting analog starts working in 50 to 120 minutes lasts up to 24 hours usually taken once a day but can be taken twice a day

T YPES OF INSULIN HUMALOG MIX 75/25, NOVOLOG MIX 70/30 premixed analog starts working in 10 to 20 minutes works the hardest 2 to 3 hours can last up to 24 hours usually taken twice a day

I NSULIN TREATMENT PLANS One shot a day- NPH, Lantus, or Levemir usually taken every 24 hours Two shots a day- 70/30, Novolog Mix 70/30, or Humalog Mix 75/25 usually taken before breakfast and dinner Four shots a day (know as basal bolus therapy)- Novolog, Humalog, or Apidra before meals and Lantus or Levemir every 24 hours

H OW DO I GET STARTED ? Insulin can be delivered by vial and syringe, by insulin pen, or by an insulin pump

I NSULIN TIPS Using vial and syringe: ALWAYS check your blood sugar before taking an insulin shot store insulin in the refrigerator throw away bottles of insulin that have been opened 30 days or longer use a new syringe for each injection insulin can be injected in the fatty tissue of the stomach, back of arms, thighs, or the buttocks. Rotate within the area and never inject over a scar mix cloudy insulin by rolling the bottle between your hands at least 20 times

I NSULIN TIPS Using an insulin pen: ALWAYS check your blood sugar before taking an insulin shot store unopened pens in the refrigerator do not refrigerate the pen you are currently using use a new pen needle with each injection do not store the pen needle on the pen never use a pen or insulin vial that has expired (the date will be on each pen)

D ISPOSAL OF DIABETES SUPPLIES Place used insulin syringes, pen needles and lancets in a plastic or metal container. examples of containers: bleach bottle, liquid laundry detergent bottle, metal or plastic coffee can When full, tape up the top, label do not recycle, and throw in the trash

S IDE EFFECTS OF INSULIN Most common side effect of insulin is hypoglycemia or low blood sugar Hypoglycemia is defined as a blood sugar below/less than 70 Symptoms: shaky hands, cold clammy skin, headache, weakness, irritable, anxious, and blurry vision Treatment: consume quick acting sugar like 4oz of juice, 6 oz of coke, 8 oz of milk, 4-5 peppermints, 3 glucose tablets, or eat 1 teaspoon of sugar Check blood sugar in 15 minutes Eat a protein snack like ½ turkey sandwich or your meal