Type 1 Diabetes: Treatment

The Injection

Whatever device you’re using to inject insulin, you should make sure you inject it into a fatty area of your body. The injection itself is subcutaneous, or just under the skin, and is usually painless or may cause a slight sting. Your healthcare provider or diabetes educator should provide you with specific instruction on your insulin injecting technique. Where you inject also impacts how quickly the insulin will begin to work. For example, insulin injected into the thigh will take longer to lower blood sugars than an insulin injection given in the abdominal area. Rotating injection sites is also a good idea. Multiple injections in the same place can cause fat deposits to build up under the skin, which can delay insulin absorption.

When you take your insulin depends on its type and action. For example, rapid-acting insulin is injected right before a meal, while the long-acting basal insulin Lantus (glargine) is typically taken once a day. Whatever type of insulin you are prescribed, your diabetes care team will explain how much insulin to take and when to take it. Going on insulin is a learning process and it may take several weeks or months to find an insulin regimen that works well for you and keeps your blood glucose levels in a safe and comfortable range. As you become more adept with treatment, you will be taught or should be taught how to adjust your insulin dose based on your self-monitored blood glucose levels.

Insulin Storage

Always store your insulin according to the manufacturer’s directions for use. Extreme temperatures can affect the potency of insulin, so keep vials and pens out of direct sunlight. Opened insulin can be kept at room temperature for up to thirty days. You should consider discarding a bottle of insulin after using it for 30 days. Other tips for insulin storage:

• Insulate. If you travel in heat or cold, carry insulin in an insulated bag that will protect it from the elements.
• Stirred, not shaken. Shaking an insulin vial or pen can cause insulin to clump and can lower its efficacy. If your insulin regimen includes NPH insulins (i.e., suspension or cloudy insulins) that require mixing to a uniform color, gently roll the vial between your palms to “stir” the insulin before drawing it up.
• Stay in the clear. Both rapid-acting and regular insulins should always be clear and free of debris and crystals. If they’re cloudy, don’t use them.
• Keep fresh. You don’t drink expired milk, so don’t use expired insulin. Insulin that has passed its expiration date may be less potent and result in high blood sugars. And once you open insulin, mark the open date on the label so you can track its remaining shelf life.
• When in doubt, throw it out. Insulin looks okay but your blood glucose is running too high for no apparent reason? Try using a fresh vial or pen of insulin and throw out the old one if it appears to be the culprit.

Reviewed by Francine Kaufman, MD. 4/08