About insulin

Insulin is a hormone made in your pancreas. It helps your body use glucose (sugar) for energy.

In type 1 diabetes, your pancreas no longer makes insulin or cannot make enough insulin. You have to inject insulin to manage your blood glucose levels.

There are different types of insulin, taken at different times.

Most people with type 1 diabetes will take 2 types of insulin:

• insulin that you take once or twice a day
• insulin that you take with food or drink

Your team will explain when to take your insulin. You get insulin on prescription.

Insulin taken once or twice a day

This is called long-acting, background, or basal insulin.

It gives your body the insulin it needs whether you eat or not. Basal insulin should keep your blood glucose stable overnight and between meals. It is important that you never miss your basal insulin.

Insulin taken with food or drink

This is called quick-acting, mealtime or bolus insulin. You usually take it before a meal, snack or drink that has carbohydrates in it.

It helps to bring blood glucose back to your target range after eating or drinking.

Counting carbohydrates

Injecting insulin

Injecting insulin should not hurt, the needles are very small.

When you were diagnosed with type 1 diabetes you should have been given:

• insulin pen
• needles

You can inject insulin in your:

• tummy
• outer thighs
• buttocks

Before you inject insulin:

• Check your insulin type matches your prescription and is in date.
• Use a new needle for every injection.
• Ideally use a 4mm pen needle for all body types for every injection.
• Make sure your hands and the area you are injecting are clean.

If you use mixed insulin, remember to correctly re-mix before injecting. Your diabetes team will tell you if you are on mixed insulin.

Rotate your injection sites. Don’t inject into same area for at least 4 weeks. · Inject at least 1cm (a finger’s width) away from last injection spot used.

Avoid injecting near your belly button, any scar tissue or lumps.

How to inject insulin:

1. Attach a new needle to the pen.
2. If it's a reusable pen, insert insulin cartridge if needed.
3. Do a 2-unit test dose before each insulin injection to ensure the needle and pen are working correctly – this is sometimes known as an ‘air shot’.
4. Dial the correct dose of insulin needed for this time of day.
5. Put the needle into your skin quickly at a 90 degree angle - at least an inch from where you last injected.
6. Inject the insulin by pressing the button down.
7. Count to 10 and then remove the needle from your skin.
8. Put the needle into a sharps bin.

When your insulin might change

When you're diagnosed with type 1 diabetes you may be asked to eat meals and inject set doses of insulin at regular times.

When you become more confident, you can use a flexible insulin treatment plan. This lets you eat when you want. Speak to your diabetes team when you feel ready.

Honeymoon period

Your body might still produce some insulin for up to a year after you are diagnosed. This is called the 'honeymoon period'.

You might find it harder to manage your blood glucose levels when the honeymoon period ends.

Speak to your diabetes team if you're finding it harder to manage. Your insulin doses will need to be adjusted.

Other things that change insulin treatment

Your treatment might need to change as you get older.

Other things may also mean your treatment needs to change, such as:

• weight changes
• being more or less active
• being ill
• pregnancy
• menopause
• periods
• stress
• using other medicines

Storing insulin

Insulin which gets too hot or freezes will not work properly. This can lead to severe blood glucose problems.

Follow these tips for storing insulin safely:

• Store insulin that is not in use in the fridge between 2 to 8 degrees Celsius.
• Store it away from the ice box in the fridge so that it never freezes.
• Store insulin that you are using at room temperature (between 8 and 25 degrees) for up to 30 days.
• Avoid storing it in places that can get too hot, for example in hot cars, next to the kitchen hob or on top of a radiator.
• Avoid storing it in places where insulin may freeze, such as in a car overnight in winter, close to the ice box in the fridge, or inside the cargo hold of an airplane.