By Meredith Kimmish
Dietetic Intern

If you or a loved one is currently living with Type 2 Diabetes, understanding the insulin regimen your healthcare provider has prescribed may be intimidating or difficult to understand. If you sometimes wonder Why am I taking this?; When should I take this?;  or Am I doing this right? you are not alone! Many people living with diabetes use different types of insulin, inject at different times of the day, and have various eating habits. But what does this all mean to you?

First let’s learn the basics on insulin:

• There are different types of insulin depending on how fast they work, peak times, and how long they last
• Insulin comes in different strengths and not everyone takes the same dosage
• Insulin cannot be taken as a pill.  It breaks down before it can be absorbed by the body. That is why it must be injected
  

Now that we know the basics, let’s look at the 3 features of insulin:

• Onset– the length of time it takes for insulin to reach the bloodstream and begins its job to lower blood sugars.
• Peak time– Time during which insulin is working at its full strength to lower blood sugar levels.
• Duration– How long insulin lasts to lower blood sugar levels.

What Insulin are you currently taking?

• Rapid acting– Insulins such as Humalog and Novolog have a short onset and are taken with meals (either shortly before, during or right after)
• Intermediate acting– Insulin such as NPH has a longer onset and duration than rapid acting, so it works between meals
• Long-Acting- Insulin such as Lantus has the longest onset time and lowers blood glucose evenly throughout the day.
• Mixed dose– NPH insulin may be mixed with a rapid acting insulin. Mixed dose is usually only used for people with a simple insulin treatment plan.

Check with your healthcare provider and/or CDE if you have any questions about your insulin.  They will work with you on the best time to take your medications.

Checking your Blood Glucose
Insulin needs are based off many factors such as body weight, food intake, physical activity, use of certain drugs, and physical or mental stress. These factors may differ day to day, therefore It is important to check your blood glucose levels regularly. Keeping a log of your blood sugar checks is a great way to help you learn how food, exercise and activity, and stress can affect your blood sugar levels. If you see that your blood sugars are too high or too low for several days, this may be a sign that you need to change your insulin regimen.

Eating Patterns and Meal Planning
Studies have shown that having meal plans and preparations ahead of time can help manage your diabetes. Remember, there is not a standard diabetes meal plan, so create one that works best for you and your lifestyle with long term goal setting.  Having scattered meal periods throughout the day can throw your blood sugar out of whack.  Creating a regular schedule for healthy meal and snack times can help manage your blood sugars by coordinating your insulin regimen with meal times.

If you would like to schedule an appointment with a registered dietitian from Massachusetts General Hospital, call the Outpatient Nutrition Counseling at 617-726-2779.

 Post content reviewed by MGH Pharmacist and Melanie Pearsall, RD, CDE