The role of insulin and the two basic types
You just returned from your follow up doctor’s appointment, and it didn’t go quite as well as expected. While you’ve followed the recommended diet, exercised, improved your sleep and implemented some stress management strategies, your A1C has increased. Your doctor is strongly considering adding insulin therapy to your treatment plan.
The stigma attached to injecting insulin has caused you to try very hard to avoid using it. However, it seems that there is no alternative for you.
Feelings of guilt and failure begin to creep in. As a result of the failure of your current treatment, you feel that you failed.
Taking insulin is not a sign of failure, my friend.
When insulin therapy is used properly, you can still live a long and healthy life. There is a good deal of planning, organizing and a lot of math skills required (no kidding!), but once you understand the role insulin plays in our bodies, you will discover that insulin therapy is a life-saving tool for managing diabetes.
The Role of Insulin
Insulin is a hormone that aids in lowering the level of glucose in the blood. In response to a rise in glucose level, such as when eating, this hormone is released into the bloodstream. In the body, glucose enters cells where it can be used for energy or stored to use later.
Any excess sugar is stored in the liver, muscles, and fat cells. In the cells, glucose reaches its normal level once it enters the cells.
The presence of low blood glucose stimulates the release of another hormone called glucagon by cells of the pancreas. Glucagon activates the liver to release the stored glucose known as glycogen from the liver into your bloodstream. Throughout the day, insulin and glucagon alternate their release in order to keep blood glucose levels stable.
A person with type 1 diabetes needs insulin therapy to replace the insulin that is not produced by the body.
The insulin therapy is sometimes necessary for people with type 2 diabetes or gestational diabetes when other treatments have not controlled blood glucose levels. Maintaining a target blood glucose level prevents complications.
Basal & Bolus
Insulin comes in two basic forms: basal and bolus.
Basal insulin is a long-acting type of insulin, also known as a “background”. Basal insulin boosts activity for about 24 hours at a time. High resting blood glucose levels can be brought down with basal insulin by providing a continuous supply of throughout the day. Basal insulin is usually taken once or twice a day to maintain consistent levels. By using basal insulin, glucose levels can remain steady even when individuals are not eating, allowing the cells to use energy more efficiently.
Bolus insulin is a more powerful, but shorter-lasting type of insulin. It is commonly taken before meals and during periods of higher blood sugar. Bolus insulin is taken at mealtimes to maintain a healthy level after eating. It is also known as “rapid-acting” insulin because it needs to work fast. Bolus insulin usually works around 15 minutes, peaks after an hour, and lasts for 2-4 hours. Bolus insulin is affected by the amount of food a person eats during a meal; therefore, it’s necessary that a person with diabetes knows how many carbohydrates they consume so that they can adjust how much insulin they need. Many people using bolus insulin use carb counting and carb-to-insulin ratios as tools.
Basal-bolus insulin therapy is an intensive insulin treatment that involves taking basal and bolus insulin simultaneously. This means that some people takes basal insulin once or twice a day and use bolus insulin at mealtime. In addition to insulin, people with type 2 diabetes may need to take oral, non-insulin medications.
Did you know that there are over 20 different types of insulin on the market in the United States? Tomorrow, I will share the five types of supplemental insulin and how each of them work.
Until Next Time,
The Genetic Diabetic