When One Insulin Shot Isn't Enough

Medically Reviewed by Michael Dansinger, MD on March 19, 2016
From the WebMD Archives

If you have diabetes and your doctor says you need more than one insulin shot a day, you may worry about how that will affect your daily routine. But there are things that can help it go smoothly.

Know the Basics of Insulin

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 to control your blood sugar around the clock.

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

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

Your doctor will let you know when, how often, and where to give yourself a shot. This will be based on:

  • Your routine
  • The kind of insulin you’re taking
  • The results of home blood sugar tests

It’ll probably 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. 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.

An insulin pump is a small machine that you wear. It pumps insulin into your body continuously, so you don't need to inject it. It’s a safe and valuable treatment option for those with poorly controlled blood sugar despite multiple daily insulin injections.

A rapid-acting inhaled insulin is also FDA-approved for use before meals only in adults with type 1 or type 2 diabetes. It must be used in combination with long-acting insulin if you have type 1 diabetes.

Test Your Blood Sugar Often

Many things can affect your blood sugar, such as:

  • Changes in your diet
  • Stress
  • Illness
  • Exercise
  • Other medications that you may be taking

Insulin can also cause low blood sugar.

"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. Keep track of:

  • 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.

Rotate the Shot Spot

Don’t inject in the same spot more than once in 2 weeks. This will keep you from getting scar tissue. If you rotate sites within one area, move an inch (about two finger widths) from the last spot each time.

Store Insulin Safely

Keep unopened insulin in the fridge. You can store opened insulin in the fridge or at room temperature. The package label will tell you how long you can keep it after opening it. You need to get rid of most opened insulin vials after 28 days and insulin pens after 10 to 24 days.

Ask Before Reusing Syringes

Ask your doctor if reusing syringes is safe for you. If you do use them again, keep the needle capped and clean. Never share needles.

Talk to a Diabetes Educator

If you have any problems with insulin treatments, a diabetes educator can give you tips that will help. An educator can also teach you how to plan ahead for things that may change your insulin routine, like travel or eating out.

For the most part, people are happier after they adjust to using insulin often, says Marjorie Cypress, PhD, RN, former president of health care and education at the American Diabetes Association.

"So many people say, 'I wish I had done it sooner. I feel so much better.'"

Don't See Multiple Insulin Shots as a Sign of Failure

"People with type 2 diabetes often feel like it's their fault if they can't get their blood sugars under control," Cypress says.

“Healthy eating and exercise can help improve blood sugar control, but diabetes is a progressive disease," she says. "Your body may be less and less able to secrete enough insulin over time."

If you have type 2 and need insulin, don't look at it as a last resort or punishment, Cypress says.

"Insulin works very well at controlling blood sugars and can be more flexible in dosing than other diabetes drugs. And with modern delivery devices, it is easy to inject."

Show Sources


American Diabetes Association: "Insulin Storage and Syringe Safety."

Marjorie Cypress, PhD, RN, nurse practitioner and diabetes educator, Albuquerque, NM; president of health care and education, American Diabetes Association.

Joslin Diabetes Center: "Diabetes Diary? Me, I'm not the journal type," "How to Improve the Insulin Injection Experience."

National Institute of Diabetes and Digestive and Kidney Diseases: "What I Need to Know About Diabetes Medicines."

Robert E. Ratner, MD, chief scientific and medical officer, American Diabetes Association.

UpToDate: "Patient information: Diabetes mellitus type 1: Insulin treatment (Beyond the Basics)."

News release, FDA.

News release, The Lancet.

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