When to start Insulin therapy
Insulin is required in all patients with type 1 diabetes.
Insulin should be strongly considered in patients with blood glucose levels consistently more than 300 mg/dL or Hb A1c level more than 10% for at least 4 months or if your HbA1c levels are frequently more than 8%.
Insulin therapy should also be considered if you have symptoms of poor glucose control including ketoacidosis, nocturia, vaginitis, fatigue or sudden weight loss.
Goals of Insulin therapy
The primary goal of insulin therapy is to maintain HbA1c levels at less than 6.5 to 7%.
What is the starting dose of insulin?
Initially it is recommended to start at 0.1 to 0.2 units per kg of your weight. But the dose could be double that, if you have severe hyperglycemia or insulin resistance is high.
What type of insulin is right for me?
Your healthcare provider will determine this based multiple factors. But generally intermediate acting human insulin such as NPH insulin is good for basal insulin.
POINTS TO REMEMBER BEFORE STARTING INSULIN
- If you had any allergic response to any type of Insulin in the past, report it to the treating doctor if starting again on Insulin.
- Inform correct and thorough medical, medication, family and substance abuse history to the treating doctor.
- Know about hypoglycemia and its symptoms. Take measures and report to the doctor immediately.
- Do not reduce or increase your dosage any time on your own unless instructed by your health care provider.
- Take meals properly after taking insulin.
- Do not operate machinery or drive if experiencing hypoglycemia. Seek help.
- Maintain a strict self-monitoring schedule of blood glucose levels.