When Insulin Isn't Enough

If you use insulin for diabetes, you still might get swings in your blood sugar levels once in a while. But what if they won't go down, even with insulin?

Don't worry. It's not the only way to get your condition under control. Healthy habits and diabetes medicine can also help.

Go Low-Tech

Some of best ways to prevent high blood sugar are old-school:

Exercise. When you do it regularly, it's like adding another medicine to your care. It makes the insulin you take work better, and it removes the sugar, or glucose, from your blood.

It also helps you lose weight, which can lower blood sugar. Try to build up to at least 30 minutes of moderate exercise most days, even if you start with just 5 minutes. Talk to your diabetes care team first about how to work out safely.

Eat right. A healthy diet keeps your blood sugar within a safe range. It's the most important way to help you shed pounds if you're overweight. Work with a registered dietitian or a certified diabetes educator to learn about the best food to eat and how to build a meal plan that works for your lifestyle.

Weight loss medications are another option you can consider if you need to get thinner. Talk to your doctor about which ones might be a good choice for you.

Relax. Stress blocks your body from releasing insulin, and that lets glucose pile up in your blood. If you're stressed for a long time, your sugar levels will keep building. Regular exercise and relaxation techniques -- like yoga, meditation, tai chi, and breathing exercises -- can help.

Increase Insulin

If the insulin you take isn't enough to lower high blood sugar, your doctor may change how much you take and how you take it. For instance, he may ask you to:

  • Increase your dose.
  • Take a fast-acting type before meals to help with swings in blood sugar after you eat.
  • Take a long-acting type once or twice a day to help give you smoother blood sugar control.
  • Use an insulin pump, which may make it easier to manage your blood sugar levels.

 

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Other Medications

You can take other drugs along with insulin to fight blood sugar highs. Some common ones are:

Exenatide and liraglutide (GLP-1 receptor agonists). If you have type 2 diabetes, these drugs lower glucose highs and make you feel full after a meal, which can help you eat less and lose weight. To take these medicines, you get a shot. They can cause some side effects, such as nausea, vomiting, weakness, or dizziness.

DPP-4 Inhibitors. These include drugs like alogliptin (Nesina), linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia). If you have type 2 diabetes, they can help you lower your blood sugar after meals. You take them as a pill. Side effects vary, depending on the type you take.

Other Reasons for High Blood Sugar

There are other possible causes of your high blood sugar, such as insulin resistance, which may run in your family. That's when your body doesn't respond as well as it should to the insulin it makes. Or, you may be taking a drug for another health problem that keeps your body from using it well.

How you use insulin can also matter. If you give yourself shots in the same place over and over, for instance, that area may scar, which can affect how your body absorbs the hormone. It helps to change spots or use an insulin pump.

Some people also take less insulin than they should. It might be because they're afraid of low blood sugar, or they're nervous about needles. You might feel more comfortable by slowly increasing your insulin dose. Consider an insulin pump or pen if you don't like needles.

Whatever the cause of your blood sugar highs, work closely with your doctor to find a solution. And always talk with him before you make any changes in your insulin dose.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on January 22, 2017

Sources

SOURCES:

American Diabetes Association: "Blood Glucose Control and Exercise," "About Our Meal Plans," "Stress," "What Are My Options?"

Diabetes Forecast: "How About Post-Meal Insulin?" "New Medications for People with Type 1?"

Michael German, MD, clinical director, Diabetes Center; director, UCSF NIH Diabetes Research Center, University of California, San Francisco.

Joslin Diabetes Center: "Diet and Diabetes: A Personalized Approach."

NIH National Institute of Diabetes and Digestive and Kidney Diseases: "What I need to know about Physical Activity and Diabetes," "What I need to know about Diabetes Medicines."

Raccah, D. Diabetes, Obesity and Metabolism, July 2008.

Sethu K. Reddy, MD, chief of adult diabetes, Joslin Diabetes Center, Harvard Medical School.

UCSF Diabetes Education Online: "Metformin," "Amylin Analog Treatment," "Incretin Based Treatments," "High Blood Sugar FAQs."

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