• Dr Stella E. Okereke-Nwokeji

Type 1 Diabetes and Insulin

Types of Insulin, Where to Inject It, and the Best Methods for Insulin Delivery

It’s necessary to take insulin when you have type 1 diabetes. Your body doesn’t produce the hormone insulin, and without that, your body can’t properly get the energy and fuel it needs from glucose. Because people with type 1 diabetes rely on insulin, it was formerly called insulin-dependent diabetes.

To learn about how the hormone insulin works, we have an article that explains the role of insulin.

As soon as you are (or your child is) diagnosed with type 1 diabetes, you will be immersed in the world of insulin, and it may feel overwhelming at first. There are doses to calculate, different types of insulin to consider, and the pressure of needing to keep blood glucose in a normal range to prevent short- and long-term complications.

Your diabetes treatment team is there to help you. They can walk you through the basics of insulin dosing, answer any questions, and help you figure out how to balance food, exercise, and insulin. You will learn to take care of your diabetes with your diabetes team. If you are a parent of a child with type 1 diabetes, we also encourage you to visit our Patients' Guide to Managing Your Child's Type 1 Diabetes.

It's often comforting to hear stories about others who are also going through the same things you are. Jay Cutler, quarterback for the Chicago Bears, was diagnosed with type 1 diabetes in 2008, and he is still getting used to regular blood sugar testing and insulin injections. To learn more about his journey with type 1 diabetes.

Types of Insulin

With type 1 diabetes, you will need to take insulin on a daily basis, and there are several types of insulin you can take. These various types of insulin each act at a different speed and serve a different purpose, and you’ll most likely take a combination of insulin.

The types of insulin are:

  • Rapid-acting: This type of insulin takes effect within 15 minutes, and you take it right before a meal. In someone without type 1 diabetes, the body releases insulin when they eat; it’s the insulin that should help them process and use the carbohydrates in the food. That release of insulin at mealtime is called the bolus secretion. Rapid-acting insulin imitates the bolus secretion.

  • Regular or Short-acting: Regular (also called short-acting) insulin takes effect within 30 minutes to an hour. It’s also taken before a meal, but its effect lasts longer than rapid-acting insulin. It is injected 30 minutes to an hour before meals. Regular or short-acting insulin also imitates the bolus secretion.

  • Intermediate-acting: This type of insulin lasts for 10-16 hours. It’s generally taken twice a day, and it’s used to imitate basal secretion. The basal secretion is the small amount of insulin that’s always in your blood (if you don’t have diabetes). In order to function efficiently, your body needs this basal secretion, so people with type 1 diabetes must take an insulin that replicates it.

  • Long-acting: Similar to intermediate-acting insulin, long-acting insulin replicates the basal secretion. Long-acting insulin lasts for 20-24 hours, so you usually take it once a day. Some people may take this type of insulin twice of day for better control of their blood sugar.

  • Pre-mixed: A pre-mixed insulin combines two other types of insulin—for example, a rapid-acting and an intermediate-acting insulin. This makes sure that you have insulin to cover the bolus and basal secretions.

How Much Insulin Should You Take?

Your doctor will calculate the dosage for you (or your child) the first time you take insulin, and he or she will work with you to figure out the best insulin plan. He or she will take into consideration your weight, age, diet, overall health, and treatment goals.

After you have the doctor’s plan, you will adjust the insulin doses, based on how your blood glucose level responds. Say, for example, that you take a certain dose before breakfast. If your blood glucose is too high afterwards, you know that you should take more insulin the next time.

Figuring out the best insulin dose is a matter of trial and error. You should work closely with your diabetes treatment team to monitor how well your insulin is working, and to adjust the insulin dose to achieve your blood sugar (blood glucose) goals.

Where Should You Inject the Insulin?

There are four main areas to inject insulin:

  • Abdomen

  • Back of Arm

  • Thighs

  • Hips/Buttocks

A few notes about insulin injection sites:

  • Insulin injected into the abdomen is absorbed (and therefore put to work) the most quickly.

  • Using the same insulin injection site over and over is not a good idea. Eventually, insulin injected at that over-used site won’t be absorbed as quickly. You should rotate injection sites.

  • How far in you inject the insulin also affects how quickly it’s absorbed. Inject the insulin under the skin.

  • The back of the arm is an area where you can inject insulin. It may be difficult to give yourself the injection in that area without assistance, so ask your diabetes treatment team for helpful techniques.

Again, your doctor and diabetes treatment team will walk you through where to inject insulin and other important details.

Newer, Easier Ways to Inject Insulin

You have many options for “insulin delivery,” as it’s called. Companies and researchers are always looking for better, less painful, and more convenient ways to get insulin into the body.

For a long time, most people used syringes and needles. Now, many people are using insulin pens and other injection devices.

Another option for insulin delivery is an insulin pump. That’s a battery-driven device that gives your body insulin, just like the pancreas does, and it does it constantly. The pump is worn externally (like a pager or cell phone, it can be clipped on your belt), but there is usually a tube and needle that send insulin under the skin.

A Final Insulin Reassurance

There are a lot of options and things to think about when it comes to insulin. However, if you can get a handle on how insulin works and its effect on your body, you will be able to manage your day-to-day life with diabetes.