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When One Insulin Shot Isn't Enough

By Camille Peri
WebMD Feature

If you have diabetes and your doctor says you need more than one insulin shot a day, you may be worried about how that will affect your daily routine. But there are a few tips that can help make your new insulin schedule go more smoothly.

Know Insulin Basics

When you're giving yourself multiple insulin shots a day, you need to know about the different types of insulin. Your doctor may want you to combine different types for around-the-clock control of blood sugar.

There are four types, based on how fast and how long they work and when they peak:

  • Rapid-acting
  • Short-acting
  • Intermediate-acting
  • Long-acting

Your doctor or diabetes educator will discuss when, how often, and where to give yourself a shot, based on your routine, the kind of insulin you are taking, and the results of home blood sugar tests. But expect it to take some trial and error to work out the right schedule and dosage for you.

There are other ways to get insulin besides a needle and syringe. For example, insulin pen injectors are easier to carry, but costly. You may decide to keep some on hand just for when you are away from home. Another option is an insulin pump, a small machine that you wear. It pumps insulin into your body continuously, so you don't need to inject it.

A rapid-acting inhaled insulin is also FDA-approved for use before meals only in people with type 1 and type 2 diabetes. It must be used in combination with long-acting insulin in patients with type 1 diabetes.

Test Your Blood Sugar Often

Many things can affect your blood sugar, such as changes in what you eat, stress, illness, and exercise and other medications that you may be taking. Using insulin can also cause low blood sugar. So you'll need to also check your blood sugar levels as often as your diabetes teams recommends.

"Anyone who takes insulin needs to monitor their glucose [sugar] levels," says Robert E. Ratner, MD, chief scientific and medical officer for the American Diabetes Association. "The only way to know when to adjust your insulin is to know when it's lacking or excessive."

Look for Patterns

Keep a daily diary to learn more about your body. Write down things such as:

  • What you eat and when
  • Your daily blood sugar readings
  • When you exercise

"Look for patterns and show it to your doctor at every visit," Ratner says. "The information will help you know what you need to do to control your blood sugar better."

You may see that your blood sugar is always high after breakfast, for example. Or maybe your morning workout lowers your blood sugar in the afternoon. Once you see patterns, you can figure out the causes and remedy them.

Is This Normal? Get the Facts Fast!

Check Your Blood Sugar Level Now
What type of diabetes do you have?
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Answer:
Low
0-69
Normal
70-130
High
131+

Your level is currently

If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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