How do I take insulin?

Most people with type 1 will be advised to start a basal-bolus or multiple daily injection (MDI) regimen. This is the most flexible way of insulin management; ideal if you have a busy life, with lots of different activities going on. Occasionally people may be advised to use fixed doses of mixed insulin. If you’re on this regime, you’ll need to stick to the same daily routine as much as possible 

Basal-bolus (also known as multiple daily injections) regimens 

This means that every day you take a background dose (also called a basal dose) in the form of long-acting insulin. This regulates your blood glucose levels throughout the day. To this, you add fast-acting analogue insulin or soluble insulin before you eat carbohydrates. This will stop your blood glucose rapidly rising after meals. 

This regimen allows you to eat at different times of the day and to vary the number of carbs in your diet, and so it is a very flexible way of managing your diabetes. However, you do need to learn how to ‘count carbs’ accurately, i.e. to work out how much carbohydrate there is in the food you eat and to adjust your insulin dose accordingly. You also need to learn how to adjust your insulin correctly when you are exercising or being more active than usual, to prevent your blood glucose becoming abnormally high or low. 

Fixed twice-daily insulin 

More rarely, and in particular, for people still getting to grips with how to manage their diabetes, or who are unable to use basal-bolus/ multiple daily injections (MDI) regimes, twice-daily pre-mixed insulin may be used. This contains a mix of short and long-acting insulin in a single injection. 

This is usually injected before breakfast and before your evening meal and so doesn’t involve any counting or calculation of doses, and people are encouraged to stick to a similar diet and levels of activity. 

People often need to try out different regimens and types of insulin until they find what works best for them and their lifestyle. It may take a little while for your blood glucose to settle down and you will probably need to spend some time adjusting doses and seeing how the insulin works in your body when you do different activities. This is all perfectly normal and your diabetes care team will give you plenty of information and support. 

What about insulin pumps?

An insulin pump is another way of administering your daily insulin.

The pump is an electronic device about the size of a small mobile phone, which delivers insulin continuously via a small plastic cannula (a thin tube) under the skin. Instead of giving yourself injections, you programme the pump to deliver different amounts of insulin at different times of day and can increase the rate at mealtimes or to correct high glucose.

It takes a lot of work to do all the calculations and get started on an insulin pump, but afterward, it has many benefits – you need fewer injections and can control your blood glucose levels more easily.

If you are considering switching to an insulin pump you should talk to your diabetes care team. You may also find our course ‘Considering an insulin pump?’ useful, you’ll find it via the eLearning homepage. Most people who try an insulin pump get on very well with it after the initial training period and hardly anyone goes back to injections after switching to using a pump.

How do you take your insulin? Does this work for you? Add your comments below.