Insulin

About insulin

Insulin is a hormone that is made naturally in the body in the pancreas. It helps to control the levels of glucose (sugar) in the blood.

If the body does not make enough insulin to meet its needs, or does not use the insulin it makes effectively, it results in the condition called diabetes mellitus (sugar diabetes). People suffering from diabetes mellitus may need treatment to control their blood sugar levels. People with type 1 (insulin dependent) diabetes are treated with insulin.

Insulin is manufactured to closely resemble natural human insulin. It can also be derived from pork or beef but this is rarely used. Insulin cannot be taken by mouth as it is destroyed by the digestive juices in the gut. It is therefore given by an injection under the skin. Insulin may come in a vial to be injected with a separate syringe, in a cartridge to be used with an injection device (pen) or in a pre-filled injection device.

There are different types of insulin available. Short-acting or soluble insulin works quickly and is usually injected just before meals. Intermediate and long-acting insulins take longer to work and the effects last longer. Biphasic insulin products contain both a short-acting and an intermediate or long-acting insulin

There are many different products available. It is very important that you use the same product each time unless your doctor or diabetic nurse tells you otherwise.

Before using insulin

Before using insulin make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you suffer from kidney problems.
• If you have ever had an allergic reaction to this or any other medicine.
• If you are taking any other medicines, including those available to buy without a prescription, herbal or complementary medicines.

How to use insulin

• Before beginning treatment, read the manufacturer's printed information leaflet.
• Use your insulin exactly as directed. Your doctor or diabetic nurse will show you how to inject yourself with insulin. It is usually injected into the upper arms, thigh, buttocks or abdomen.
• As no two people are alike, treatment may consist of one or more types of insulin with the amounts you use carefully chosen to suit your requirements. Ask your doctor or nurse if you are unsure of your dose.
• Insulin doses are referred to in terms of units. Make sure you know how much to use.
• Some types of insulin require mixing, check with your pharmacist if you are unsure. Mix insulin well by rolling the bottle slowly between the hands or by tipping the bottle upside down and gently rotating. Do not shake the insulin as frothing or bubbling can cause an incorrect dose. Do not use the insulin if: the contents look lumpy, if any particles stick to the sides or bottom of the vial, or if a white substance remains at the bottom of the vial.

Getting the most from your treatment

• You must test for sugar in the blood or urine to make sure that you are using the right dose of insulin for you. Your doctor or diabetic nurse will show you how to test your blood sugar and how to use the results of the test.
• Check with your doctor before taking up any physical exercise as this will have an effect on your blood sugar levels, which can last for hours.
• Check with your doctor if you develop an infection, you may need a change in dosage.
• Change the injection site on your body regularly to help prevent skin problems and difficulties in injecting.
• Check you have been given the correct insulin each time you collect your prescription.
• Keep your regular doctor's and clinic appointments so your progress can be monitored.
• Do not drink alcohol on an empty stomach as this could cause severe hypoglycaemia (low blood sugar).
• If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment you are diabetic and using insulin.
• If you buy any medicines, check with a pharmacist that they are safe to take with insulin.
• Drivers should take special care on long journeys. It is recommended that you check your blood sugar levels every two hours. If hypoglycaemia occurs, stop the car in a safe place, eat or drink something sugary, and wait at least fifteen minutes before continuing on your journey.
  
  Signs of hypoglycaemia (low blood sugar):
  
  Anxiety, cold sweats, confusion, headache, feeling sick, being sick, nervousness, palpitations (being aware of your heartbeat), shaking, unusual tiredness, weakness, and eyesight problems.
  
  
• If you over-eat, do not follow a proper diet, have a fever, or take too low a dose of insulin, you may experience signs of hyperglycaemia.
  
  Signs of hyperglycaemia (high blood sugar):
  
  Drowsiness, flushed face, fruity smell on breath, increased urination (passing water), loss of appetite or unusual thirst. Severe symptoms may include rapid pulse and heavy breathing.
  
  If you experience these symptoms, check with your doctor or diabetic nurse immediately.

Can insulin cause problems

• You may experience soreness at the injection site.
• Too high a dose can cause hypoglycaemia (low blood sugar).

How to store insulin

• Keep all medicines out of the reach of children.
• Store in a fridge before use but do not freeze. Once in use insulin can be stored outside a fridge in a cool dry place, away from direct heat and light. Once opened a vial can be used for up to 28 days.

Important information about all medicines