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Frequently asked questions about diabetes and insulin

Should I be worried about starting on insulin treatment for type 2 diabetes?

Moving on to insulin treatment can seem like a big step. You may feel frustrated that your previous treatment didn't work or worry that injections will be painful, or at least inconvenient.

 

 

How do I take insulin?

Insulin is an injectable medicine made up of insulin hormone suspended in a solution. Unfortunately, insulin cannot be taken as a tablet - it would be destroyed by your digestive system before it could start working.

Most people with type 2 diabetes use an injectable pen to take insulin. Injection pens are designed to be discreet and easy to use. There is a broad range available to suit different needs, including pre-filled and refillable pens. Some even have a hidden needle.

Your healthcare professional will be able to recommend the pen and injection schedule that best suits your lifestyle and will show you how to administer injections yourself.

How will my daily life be affected when I start on insulin?

Insulin treatment doesn't have to slow you down. Once you've mastered your injection technique, you'll find it only takes a minute or two and can be done almost anywhere. Insulin pens are light, easy to carry and ultra-discreet. 

You don't need to keep the insulin you are using in the fridge all the time, you can also store it between 2°C and 8°C (35°F and 47°F). Your open disposable pen or insulin cartridge will last four weeks at room temperature (not above 30°C) or fridge (2°C to 8°C). Just don’t leave it in a car or anywhere it could get too hot or cold.

What about high blood sugar (hypers) & low blood sugar (hypos) with insulin?

High blood sugar, also known as hyperglycaemia – or a 'hyper' – can make you to feel unwell. Knowing the warning signs (thirst, hunger, excessive urination) and how to deal with them is the best way to overcome anxiety. 

Low blood sugar levels are called hypoglycaemia or hypos, and you can read about them here. Speak to your doctor or diabetes care team about how to manage your blood sugar, and avoid hypos and hypers. Your doctor will be able to help you adjust your dose.

Will I gain weight?

People often put on weight when they start insulin treatment, although the amount gained differs from person to person. Some people do not put on any weight at all. Why does this happen? 

When your diabetes is not well controlled, excess blood sugar is flushed out in your urine. Starting on insulin treatment improves your body's ability to absorb glucose from the food you eat, and what you don't use for energy gets stored as fat. This means you may put on weight, even if you eat the same amount as before. You may also gain weight if you snack more to avoid hypoglycaemia.

How can I avoid weight gain on insulin treatment?
  • Talk to your doctor about how to best manage your weight
  • Take regular exercise
  • Eat a healthy, balanced diet
  • Monitor your weight weekly when you start on insulin
  • Monitor your blood sugar so you know you don't have to snack

References
  1. American Diabetes Association. Standards of Medical Care in Diabetes—2012. Diabetes Care 2021; 35 Suppl 1:S11–63.
  2. Diabetes UK. Insulin and diabetes. Available from: https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/insulin Last accessed: January 2024.
  3. Diabetes UK. Injecting insulin and children. Available from: https://www.diabetes.org.uk/guide-to-diabetes/your-child-and-diabetes/insulin-and-your-child Last accessed: January 2024.
  4. Novo Nordisk A/S. Fiasp® FlexTouch® package leaflet: information for the patient. Available from: https://www.medicines.org.uk/emc/files/pil.2447.pdf Last accessed: January 2024.
  5. Novo Nordisk A/S. NovoRapid® FlexPen® package leaflet: information for the user. Available from: https://www.medicines.org.uk/emc/files/pil.7920.pdf Last accessed: January 2024.
  6. Novo Nordisk. NovoPen Echo® Instructions for Use. Available from: https://www.novonordisk.com/content/dam/nncorp/global/en/our-products/pdf/instructions-for-use/novopen-echo/NovoPenEcho-UK.pdf Last accessed: January 2024.
  7. Novo Nordisk. NovoPen® 6 Instructions for Use. Available from: https://www.novonordisk.com/content/dam/nncorp/global/en/our-products/pdf/instructions-for-use/novopen-6/Novopen6-UK.pdf Last accessed: January 2024.
  8. Novo Nordisk. NovoPen® 5 Instructions for use. Available from: https://www.novonordisk.com/content/dam/nncorp/global/en/our-products/pdf/instructions-for-use/novopen-5/NovoPen5-UK.pdf Last accessed: January 2024.
  9. International Diabetes Federation Europe. Storage of insulin. Available from: https://idf.org/images/IDF_Europe/Storage_of_Insulin_-_IDF_Europe_Awareness_Paper_-_FINAL.pdf Last accessed: January 2024.
  10. Penckofer S, Quinn L, Byrn M, et al. Does glycemic variability impact mood and quality of life? Diabetes Technol Ther 2012; 14:303–310.
  11. NHS UK. Hyperglycaemia (high blood sugar). Available from: https://www.nhs.uk/conditions/high-blood-sugar-hyperglycaemia/ Last accessed: January 2024.
  12. NHS UK. Low blood sugar (hypoglycaemia). Available from: https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/ Last accessed: January 2024.
  13. American Diabetes Association. Obesity Management for the Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes 2021. Available from: https://diabetesjournals.org/care/article/44/Supplement_1/S100/30970/8-Obesity-Management-for-the-Treatment-of-Type-2 Last accessed: January 2024.
  14. Diabetes.co.uk. How to Bring down high blood sugar levels. Available from: https://www.diabetes.co.uk/how-to/bring-down-high-blood-sugar-levels.html Last accessed: January 2024.
  15. Diabetes.co.uk. Insulin and Body issues. Available from: https://www.diabetes.co.uk/teenagers/insulin-and-body-issues.html Last accessed: January 2024.
  16. Diabetes UK. Checking your blood sugar levels. Available from: https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/testing Last accessed: January 2024.

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