Insulin for type 2 diabetes

What is insulin?

Insulin is a hormone that allows glucose to move from the bloodstream into body cells where it can be used for energy.

Why do some people with type 2 diabetes need to inject insulin?

When you have type 2 diabetes, your body does not make enough insulin, and/or is unable to use the insulin it is producing. This causes blood glucose levels to rise. This is known as hyperglycaemia (high blood glucose). Having a healthy diet, getting regular physical activity and taking glucose lowering medication can help your body to keep blood glucose in the recommended target range.

Over time, the type and dose of medication you need is likely to change. It is important to understand that this is the natural course of type 2 diabetes. If other medications are not keeping your blood glucose levels in target, you may need insulin injections. Insulin is very effective for bringing blood glucose levels into target range. To learn more about the different medications for type 2 diabetes, look at the factsheet: ‘Medications for type 2 diabetes’.

For many people, insulin is recommended several years after diagnosis of diabetes – but some people may benefit from taking insulin much earlier, even when they are first diagnosed. Everyone is different. You might be interested to know that just over 260,000 Australians manage their type 2 diabetes with insulin. That is 1 in 4 people with type 2 diabetes.

Where to access support for starting insulin?

Adjusting to new diabetes treatments can be hard. Many people with type 2 diabetes have worries or feel anxious about starting insulin therapy. If you feel this way, you are not alone. If you’re unsure about starting insulin injections, you can also read the factsheet: ‘Concerns about starting insulin (type 2 diabetes)’.

Your health professionals are there to advise and help you with all aspects of your diabetes, including how you feel about insulin. They can provide information and advice to help you to decide what diabetes treatment is best for you and support you as you start new medications. In addition to your doctor, you might like to visit a Credentialled Diabetes Educator. Diabetes Educators are trained to provide diabetes self-management education. They can teach you how to prepare, inject, and store insulin and answer any questions you might have about insulin.

Learning more about diabetes and insulin can help you feel less worried. You might like to attend an education session or join a diabetes peer support group so you can talk with other people with type 2 diabetes who are taking insulin. Call the free NDSS Helpline to find information about diabetes education and peer support groups available near you.

If you feel comfortable, you might also find it helpful to talk with your family and friends. Sharing how you feel can help them understand how best to support you.

Read more about the role of insulin in the management of type 2 diabetes in our Starting insulin booklet.

Benefits and side effects

What are the possible benefits of taking insulin?

Taking insulin will lower your blood glucose levels and improve your long-term health. Keeping your blood glucose levels in the recommended target range reduces your risk of long-term complications, and can prevent any complications you already have from getting worse.

Taking insulin can also make you feel better. This is because keeping blood glucose levels in target range gives you more energy to live your life as you want.

What are the possible side effects of taking insulin?

When used correctly, insulin is very safe. It is important to understand that insulin does have some side effects.

Taking insulin increases the risk of hypoglycaemia or ‘hypo’ (low blood glucose). That is, a blood glucose level below 4mmol/L. Common causes of a hypo include taking too much insulin, not eating enough carbohydrates, or being more active than usual. Most people taking insulin can recognise and self-treat hypos. Your health professional can advise you on how to prevent, recognise and treat hypos. More information is available in the factsheet: ‘Managing hypoglycaemia’.

Taking insulin can lead to some weight gain (usually 1-3 kg). When you have high blood glucose, your body is unable to turn its glucose into energy. The kidneys get rid of this extra glucose through the urine. This causes the common symptoms of high blood glucose levels: passing a lot of urine, extreme thirst and feeling tired. This can make you dehydrated and you may lose weight – but it’s not a healthy weight loss. After you start taking insulin, your body is better able to turn the glucose from your food and drink into energy. This means you may gain some weight in the short term. You can discuss weight management options with your health professional.

Types of insulin

Insulin acts by lowering the level of glucose in your blood. When glucose is at its lowest level, the effect of the insulin is said to have reached its 'peak'. After this, the effect gradually wears off and blood glucose levels rise. There are five types (or classes) of insulin. Each type differs in how quickly it reaches its peak and how long the insulin works in the body. You can read more about the different types of insulin in the factsheet: ‘Insulin’.

Your insulin needs can also change over time. You may need to change your insulin dose or type, or use more than one type of insulin. It is important to have regular reviews of your diabetes management with your health professional.

Administering Insulin

How is insulin taken?

Insulin can only be injected. At the moment, it cannot be given in tablet form, because it would be destroyed in the stomach and would not work.

Insulin works best when it is injected into the fatty layer just below the skin and above the muscle. This is known as the subcutaneous layer. The injection site affects how quickly the insulin works. For example, the tummy (abdomen) absorbs insulin the fastest. Most people inject into their tummy but some people prefer to inject their buttocks or thighs. It is important to inject in a slightly different place each time and inject insulin at a 90 degree angle to the body.

When starting insulin, your health professional will teach you how and where to inject your insulin as well as how to look after your insulin. Some people worry about injecting themselves at first. These days, insulin injection systems have very fine needles that can be used with minimal discomfort. Remember, it can take time to get used to a new treatment, but your health professional is there to help and support you.

You can read more tips about injecting insulin, insulin storage and sharps disposal in the fact sheet: ‘Insulin’.

Insulin injection devices

Insulin is most commonly injected using an insulin ‘pen’ or a syringe (where you draw up insulin from a vial or bottle). Many people find using an insulin pen easier and more convenient than syringes. If you have problems with your eyesight or arthritis in your hands, you may find an insulin pen easier to use. Each type or brand of insulin has its own type of pen. It is important that you use the insulin pen that has been made to match your insulin. Some insulin pens are made in different sizes depending on the quantity of insulin being injected. Talk with your diabetes health professional about what insulin injection device is best for you and how to use the device.

Monitoring your blood glucose

People who take insulin need to self-monitor their blood glucose levels. This is usually done with a finger prick device and blood glucose meter. Regular monitoring can help you see the effects of food, drink, physical activity, medication and illness on your blood glucose levels. It can also help you identify any patterns or changes in your blood glucose levels. Your health professional will help you decide when and how often you should check your blood glucose levels, and your target range. Read more in the fact sheet: ‘Blood glucose monitoring’.

More information

Call the NDSS Helpline 1300 136 588

Diabetes Australia offers a free national NDSS Helpline, through which people with diabetes and their carers can access diabetes information, education programs, peer support groups, and events.

Page last reviewed: 31 October 2018

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