Managing your diabetes with insulin

Insulin is a hormone that helps move glucose from your blood into your cells for energy. You will need to take insulin if you have diabetes because your body may not produce enough insulin or may not use it effectively. The aim is to keep your blood glucose level as close to normal as possible (4 to 8 mmol/L). Find out how to take insulin, the different ways to take it and what to do if your blood sugar levels are low.

Types of insulin

Your healthcare provider will recommend the right type and dose of insulin to manage your blood sugar levels. There are 4 different types of insulin you can take.

  • short-acting (clear) insulin. This helps control blood sugar spikes after meals
  • intermediate-acting (cloudy) insulin. This helps regulate blood sugar levels between meals and overnight
  • long-acting insulin. This gives steady blood sugar control throughout the day and night
  • mixed insulin. A combination of different insulins to provide balanced blood sugar control.

How to take insulin

There are several ways you can take insulin.

Insulin pen

Using an insulin pen — a device containing a cartridge prefilled with insulin — is the most common way to inject insulin.

Insulin pump

An insulin pump delivers insulin continuously through a thin tube under the skin. Talk to your healthcare provider to see if a pump is right for you.

Mixing your insulin

If you use cloudy insulin, mix it properly before injecting.

  • Insulin pen — gently 'rock and roll' the pen to gently mix the insulin until it looks cloudy and is no longer separated.
Always check the expiry date before use.

Preparing to inject insulin

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Draw slightly more insulin than required, then discard the excess. Do not return it to the vial to avoid contamination.

  1. Wash your hands and prepare a clean surface.
  2. Check the pen – make sure the cartridge is not cracked, insulin is clear, and it is within expiry date.
  3. Prepare the pen:
    • Remove the cover and unscrew the top.
    • Insert a new cartridge (threaded end first) and reattach the top.
    • Attach a new pen needle and tighten it securely.
  4. Prime the pen – dial 2 units and press to ensure insulin flows. Repeat if necessary.

How to inject insulin

  1. Dial the correct dose as prescribed by your healthcare provider.
  2. For cloudy insulin, shake gently before use.
  3. Choose an injection site:
    • inject into the fatty layer of your tummy
    • rotate sites to prevent lumps or skin damage
    • avoid injecting through clothes or into damaged skin.
  4. Inject the insulin:
    • pinch a small area of skin
    • insert the needle at a 90-degree angle
    • press the plunger fully
    • count to 6 before removing the needle.
  5. Store the pen properly after use.

Changing the needle

  • Rapid-acting (clear) insulin– change the needle every 1 to 4 days.
  • Intermediate-acting (cloudy) insulin – change every 1 to 3 uses.
  • Always prime the pen (release 2 units) after replacing a needle.

What to do with used needles

  • Put used needles in a hard plastic container away from tamariki.
  • Do not dispose of them in your rubbish or recycling.
  • Take sealed containers to a pharmacy for safe disposal.

If you forget to take your insulin

If you forget your pre-meal insulin take it directly after your meal.

If it has been longer than 30 minutes after your meal, skip that insulin dose altogether.

Managing low blood sugar (hypoglycemia)

Hypoglycaemia (hypo), means you have a low blood glucose (sugar) level. Any blood glucose level less than 4 is low.

Symptoms of low blood sugar

Blood sugar below 4.0 mmol/L is low. Symptoms include:

  • headache, dizziness, sweating, shaking
  • fast heartbeat, irritability, anxiety
  • blurred vision, hunger, extreme tiredness.

Treating low blood sugar

  1. Eat or drink a fast-acting sugar source:
    • 1 tbsp jam, honey, or sugar
    • half a glass of regular lemonade or fruit juice
    • 6 large jellybeans
  2. Wait 5-10 minutes, then check your blood sugar.
    • If still below 4.0 mmol/L, repeat step 1.
  3. Once it is above 4.0 mmol/L, eat a carbohydrate snack (bread, crackers, milk) if it’s not mealtime.
    • If taking insulin before meals, take it halfway through the meal.

Preventing low blood sugar

Reduce your risk of low bloody sugar by:

  • eating meals regularly with enough carbohydrates
  • adjusting insulin for physical activity
  • avoiding excessive alcohol on an empty stomach
  • taking insulin at the correct time.

Storing insulin

  • Unopened insulin – store in the fridge (2-4°C) until expiry.
  • Opened insulin – keep at room temperature and discard after 4 weeks.

Do not

  • store insulin in direct sunlight
  • freeze insulin
  • leave in a hot place or in your car.

Travelling with insulin

If you are travelling:

  • carry your insulin in an insulated container
  • keep it in your hand luggage.

Adjusting your insulin dose

Your insulin needs may change if :

  • there are changes in your diet
  • you are exercising more than usualyou are ill and not eating
  • regularly
  • you are pregnant.

Your healthcare provider will help you adjust your insulin dose safely. Over time, you will learn to make small adjustments based on self-testing and how your body responds.

Related information

Living well with diabetes (internal link)