Type 2 Diabetes and Insulin

When dietary changes, exercise, and medications don't work

Written by Lisa M. Leontis RN, ANP-C, Amy Hess-Fischl MS, RD, LDN, BC-ADM, CDE
People with type 2 diabetes do not always have to take insulin right away; that is more common in people with type 1 diabetes. The longer someone has type 2 diabetes, the more likely they will require insulin. 
Just as in type 1 diabetes, insulin is a way to control your blood glucose level. With type 2 diabetes, though, dietary changes, increasing physical activity, and some oral medications are usually enough to bring your blood glucose to a normal level. To learn about how the hormone insulin works, we have an article that explains the role of insulin.
There are several reasons people with type 2 diabetes may want to use insulin:
If you do decide to use insulin to help control your type 2 diabetes, you should learn all you can about it. Talk to your doctor and diabetes treatment team. They can walk you through the basics of insulin dosing, answer any questions you have, and help you figure out how to balance food, exercise, and insulin as you take care of your body.
Read on to learn more about the basics of insulin treatment. You can also visit our Patient Guide to Insulin for more details.
Types of Insulin
There are several types of insulin you can take. Each type serves a different purpose, and you might need to take a combination of the following:

How Much Insulin Should You Take?
Your doctor will calculate the correct dosage for you the first time you take insulin, and he or she will work with you to figure out the best insulin plan. He or she will take into consideration your weight, age, diet, overall health, and treatment goals.
After you have the plan, it is recommended to work with your healthcare professional or a certified diabetes educator (CDE) to teach you how to adjust the insulin doses, based on how your blood glucose level responds. Say, for example, that you take a certain dose before breakfast. If your blood glucose is too high afterwards, you know that you should take more insulin the next time. You should seek your diabetes treatment team’s advice before changing your dose.
As imprecise as it sounds, figuring out the best insulin dose is a matter of trial and error. You should work closely with your diabetes treatment team to monitor how well your insulin is working, and to adjust it as necessary.
Where Should You Inject the Insulin?
There are four main areas to inject insulin:
 A few notes about insulin injection sites:
Your doctor and diabetes treatment team will walk you through where to inject insulin and other important details.
Newer, Easier Ways to Inject Insulin
You have many options for “insulin delivery,” as it’s called. Companies and researchers are always looking for better, less painful, and more convenient ways to get insulin into the body.
For a long time, most people used syringes and needles. Now, many people are using pens.  They can be more expensive than vials and syringes, though.
Another option for insulin delivery is an insulin pump. This is a device that gives your body insulin, just like the pancreas does, and it does it constantly. The pump is worn externally, but there’s a tube and needle that send insulin under the skin. An insulin pump requires more training to learn how to use it.
A Final Note about Insulin
Often after having type 2 diabetes for a long time, oral medications may not work as well as they used to. If that happens, insulin is a way to keep blood glucose (blood sugar) levels in control. In combination with a healthy meal plan, increased physical activity, and medications, insulin can control your blood glucose level and keep it in a healthy range.



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Introduction: Medications for Type 2 Diabetes