Diabetes is treated with oral medications and insulin. Insulin therapy is a treatment that you inject into your own body. Now let's talk about insulin therapy.
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Indications for insulin therapy
Types of diabetes include type 1 diabetes and type 2 diabetes. In both cases, the hormone “insulin”, which prevents blood sugar from overflowing into the blood, is not secreted as usual.
Type 1 diabetes refers to those who are unable to secrete insulin for some reason during childhood.
Type 2 diabetes refers to those who have trouble secreting insulin due to lifestyle habits such as overeating and lack of exercise. In type 2 diabetes, insulin secretion is reduced or almost non-existent.
As a result, it becomes necessary to administer insulin artificially. Insulin therapy is indicated for people with type 1 diabetes and people with type 2 diabetes who have little insulin secretion.
Insulin therapy is used when diabetes control becomes more necessary than oral therapy. Depending on the patient, insulin therapy and oral therapy may be used together.
reference)
How drugs lower blood sugar levels | Diabetes Information Center (ncgm.go.jp)
Type of insulin treatment
There are two types of insulin injections. One is The GLP-1 (GLP-1) receptor agonist and the other are insulin preparations.
GLP-1 receptor agonists increase insulin secretion and are used for type 2 diabetes.
Insulin preparations supplement insulin itself and are used by people with type 1 diabetes and people with severe type 2 diabetes.
There are more types of insulin preparations. Here are some representative examples.
Super fast attack type
Apply just before meals and it will take effect in about 10 minutes. The effect lasts for only 3-4 hours.
quick attack
Apply 30 minutes before meals and the effect will be seen in about 30 minutes to 1 hour. The effect lasts for only 5-8 hours.
intermediate type
Hit once a day at a fixed time, regardless of when you eat. It will take effect in about 30 minutes to 3 hours. The effect lasts for 18-24 hours.
long-acting
Hit once a day at a fixed time, regardless of when you eat. It will take effect in about 1-2 hours. The effect lasts for about a day.
The super fast-acting type and fast-acting type are used for patients with particularly high postprandial blood glucose levels, while the intermediate and long-acting types are used for patients with consistently low insulin secretion.
In any case, what you use is determined by the doctor's judgment based on the results of the examination and lifestyle including diet.
reference)
Injectable drug that lowers blood sugar level | Diabetes Information Center (ncgm.go.jp)
How to use insulin injections
Insulin injections must be taken before meals or once a day, so you will have to inject yourself. You will receive instructions from your nurse or pharmacist in advance, so follow the directions for use and dosage.
① First, wash your hands.
② Prepare an insulin injection body, a needle, and an alcohol swab.
③ Remove the lid of the main body and connect the needle removed from the cap.
* Disinfect the connection between the main unit and the needle before connecting the needle.
④ I'm going to hit the air to get the air out.
Turn the dial on the main unit and set it to 2 units (unit: how to count the amount of insulin). Then press and hold the injection button until it reaches 0 units.
⑤ Turn the dial to set the indicated dose unit.
⑥ Disinfect your subcutaneous area.
Injections are made into subcutaneous fat. Subcutaneous fat is the fat that you can pinch yourself. Common areas include the abdomen, buttocks, upper elbows, and thighs. The abdomen is chosen as the first choice because it is easy to pinch the subcutaneous fat and it is the part that you can see well.
⑦ Hold the main unit, insert the needle under the skin, and keep pressing the injection button until the dial reaches 0. If you leave the sting for about 10 seconds, it will definitely be injected.
⑧ Pull out the needle, remove the needle from the body and put on the cap.
*Because needles are medical waste, put them in a single bag and ask them to dispose of them at the next outpatient clinic or at the pharmacy. Do not dispose of them together with household garbage.
As a point for continuing insulin injections, shift the position little by little even in the same place (for example, the stomach). Since it is done every day, if you continue to hit the same spot, the skin may become hard. Please note that the absorption of insulin injections will be poor in that part.
reference)
Injectable drug that lowers blood sugar level | Diabetes Information Center (ncgm.go.jp)
Pay attention to hypoglycemia when injecting insulin
Hypoglycemia means that your blood sugar level is too low. Symptoms include sweating, light-headedness, trembling hands, and sometimes loss of consciousness, which can be life-threatening.
There are several causes, and it is likely to occur when you are hungry for too long, you have drastically reduced carbohydrates, you have exercised excessively, or you have injected insulin but you have not eaten enough.
In addition, when you fast during a health checkup or medical checkup, you basically do not need to inject insulin before meals.
If you forget this and only inject insulin, the risk of hypoglycemia increases, so be careful.
Before undergoing a physical examination, please check with your doctor about whether or not you should take insulin injections.
Also, if symptoms such as hypoglycemia persist, consult your doctor. You may need to adjust the dosage of your insulin injections.
summary
Today, we are talking about insulin therapy. Injecting insulin is a self-administered medical procedure. Understand the treatment yourself, learn the correct injection method, and pay attention to any changes in your physical condition. And if you have any questions or concerns, talk to your doctor.
Let's aim for a better life while coping well with diabetes.
Supervision: Dr. Yasushi Tsuda