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Introduction To Insulin |
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This page is intended to give you some practical advice about the use of insulin. If you have questions about how much insulin you should be on or other particular queries, please consult your diabetes team.
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Types Of Insulin |
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Insulin can unfortunately be given only by injection, although a lot of work is being done to develop other ways of giving it and these may be available fairly soon.
There are several types of insulin. They are classified by how quickly they start to work: very fast, fast, slow and very slow acting. The "onset" is the time that it takes for the insulin to start working after it is injected under the skin. Each type of insulin has a so-called "peak" when it is working hardest to lower blood sugar. Each insulin works for a certain length of time called its "duration of action". These times vary quite a lot from person to person and for reasons such as hot weather (speeds up insulin action), cold weather, injecting into fatty lumps, injecting into thighs rather than tummy (slow down insulin action).
This table gives usual action times for some commonly used insulins:
| Insulin |
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Onset |
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Peak Action |
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Duration |
| Humalog or Novorapid |
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15 min. |
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1/2hr - 1 1/2hrs |
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3-5 hrs |
| Actrapid or Humulin S |
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30 min. |
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2-4 hrs |
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6-8 hrs |
| Insulatard or Humulin I |
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1-3 hrs |
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6-12 hrs |
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18-24 hrs |
| Ultralente |
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approx. 4-8 hrs |
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12-18 hrs |
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approx. 24-28 hrs |
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Most people take either two or four injections of insulin per day. Your diabetes team will discuss with you which types of insulin they think will suit you best and why. It will be largely up to you whether you choose to inject twice or four times per day, but your diabetes team will advise you according to your wishes plus lots of other factors.
Animal insulins (pork and beef) are still available on prescription but are not used very widely in Nottingham. The issues surrounding the use of animal insulin can be discussed with your diabetes care team.
More information on insulin types and how they are given is available on the Joslin Diabetes web site, based in America. The diabetes UK web-site contains information about insulin pens and blood sugar monitoring equipment.
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Storage |
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Store in a cool, dark, place, preferably in a fridge (not in the freezer section ) and out of reach of children. The insulin container in use may be kept at room temperature, but spare insulin must be kept in the fridge. To avoid waste it is advised not to 'overstock' as type of insulin may be changed, but always keep a spare bottle in case of breakage. Insulin kept out of the fridge that has not used within one month should be thrown away. Insulin opened but kept in the fridge should be discarded after 3 months.
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Supply |
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You can get more insulin on prescription from your GP. People with diabetes are entitled to a Family Practitioner Exemption Certificate by which all prescriptions are free of charge. A claim form FP92A can be obtained from the Post Office, DSS or Pharmacy and needs to be signed by a doctor.
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Expiry Date |
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Check the expiry date when starting a new container of insulin.
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Syringes And Needles |
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Disposable syringes and pen needles are available on prescription. Most people safely re-use their disposable needles several times and throw them away when they start to feel uncomfortable. If using a syringe, give a quick couple of pumps of the plunger to make sure that there is no insulin left in the needle, replace the cap and store in a safe place (e.g. fridge or bathroom cabinet).
Make sure that no one can accidentally stab themselves with your used needle.
If someone else draws up your insulin for you, they should use a fresh syringe and needle each time so that they cannot accidentally stab themselves with a used needle.
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Safe Disposal Of Syringes, Needles And Lancets |
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Before discarding always clip off needle using a 'safe clip' needle clipper. These are available on prescription and can store up to 200 needles. When full it can be thrown away in the rubbish bin. The remainder of the syringe or pen needle can be put in a plastic bottle or jam jar, sealed when full and put in the rubbish.
Safe disposal is extremely important - Make sure the used syringe, needle or lancet cannot injure or be used by anyone else.
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Bleeding |
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Occasionally you may bleed from the injection site. If this happens, just hold a finger firmly over the area for a few seconds. You will not have lost any insulin.
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Bruising |
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Also occasionally a bruise may appear. Don't worry - just avoid the area until it has gone. The injection is usually painless, but very occasionally it may hurt a little - don't be put off.
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Injection Sites |
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The usual places for injections are the abdomen, the upper thighs and the buttocks. Avoid the arms. Vary the site and point of the injection. Repeated injections into the same area can result in fatty lumps (lypohypertrophy). Insulin may not be absorbed properly from sites where lumps have developed and this can affect your blood sugar control.
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Blurred Vision |
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Occasionally this may happen during the first few weeks on insulin. Although a nuisance, it is temporary and due to the high blood glucose which affects the ability of the lens to adapt properly. Your ability to focus will return in about a month as your blood glucose improves. There is no need to visit the optician at this time. Change in vision may have driving implications - see advice on driving and insurance.
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