Diabetes is a disease in which blood glucose (sugar) levels are higher than normal. Glucose is produced in the body from the foods that you eat. The pancreas, an organ located in the abdomen just behind the stomach, produces insulin. Insulin is a hormone that takes glucose from the bloodstream and carries it into your body’s cells where it is used for energy.
Diabetes occurs when the pancreas does not produce enough insulin or when the body doesn’t use insulin properly (called insulin resistance). Sometimes people have both problems. In either case, the result is that glucose does not enter the cells and builds up in the blood.
Over time, uncontrolled diabetes may cause serious complications including heart disease, stroke, kidney failure, blindness, and nerve damage. Keeping blood glucose levels close to normal is the key to preventing these health problems.
Different types of insulin have different effects on the body.
Treatment depends on the type of diabetes you have. There are three main types of diabetes:
Treatment includes changes in lifestyle (diet and exercise), plus medicine (if needed): oral medicines (pills), insulin, and/or other injected medicines. People with type 1 diabetes always need insulin. People with type 2 diabetes usually need treatment with oral medicines for several or even many years, but may eventually need insulin to maintain glucose control.
Different types of insulin are classified by how fast they work and how long they continue to work in the body.
Mealtime (or “bolus”) insulin. Used before meals to control the rise of blood glucose levels after eating.
Basal insulin. Controls blood glucose levels between meals and throughout the night. This is usually used once or twice daily. It can be used alone or in combination with oral medicines or rapid-acting insulin.
Pre-mixed insulin. Combination of bolus and basal insulins that controls blood glucose levels after and between meals. These are usually used twice daily before breakfast and dinner. They can be used alone or in combination with oral medicines.
The type of insulin your doctor prescribes will depend on the type of diabetes you have, your lifestyle (when and what you eat, how much you exercise), your age, and your body’s response to insulin. It also depends on how often you are able or willing to check your blood glucose and give yourself injections.
People with type 1 diabetes often need more than one type of insulin. Most people with type 2 diabetes who use insulin just use basal (long-acting) insulin.
In recent years, scientists have developed new products called insulin analogs. These have been genetically engineered to better match the insulin produced by your pancreas.
Insulin analogs make it easier to control blood glucose. By controlling and preventing hyperglycemia (high blood glucose) and hypoglycemia (low blood glucose), they may reduce the risk of diabetic health problems and improve your quality of life.
Like traditional insulins, insulin analogs are injected with a syringe, an insulin pen, or an insulin pump. Insulin analogs include long-acting, basal insulins (glargine and determir) and rapid acting, bolus insulins (lispro, aspart, and glulisine).
Some insulin analogs have not yet been approved for use during pregnancy. If you are or plan to become pregnant, talk with your doctor about the best insulin for you.
If you have diabetes, you should maintain a healthy lifestyle and learn as much as you can about your condition. Follow your doctor’s recommendations for treatment and regularly monitor your blood glucose to avoid high or low blood glucose. You can manage your diabetes with diet, exercise, and medicines (if needed).