Having insulin-dependent diabetes means a lifelong dependence on daily injections of insulin. In addition to people with type 1 diabetes, those with type 2 diabetes that is unresponsive to oral drugs must also take insulin.1
A typical patient with type 1 diabetes may need more than 60,000 injections across their lifetime, requiring two or more injections every day.2
Practical advice for injecting insulin
With practice and good technique, injecting insulin can become more comfortable. The needle is very small, and injection is not into a muscle or vein but under the skin. The three areas of skin most commonly used are the stomach, the buttocks and the thighs.
- Avoiding the belly button, the inner thigh, the lower buttock, scars and broken blood vessels or varicose veins
- If using the thigh, keep injections at least 4 inches below the top of the leg and above the knee
- If using the arm, inject into the fatty area at the back, between the shoulder and elbow
- If using the buttock, use the hip area.
Insulin side effects
Very rarely, a serious and life-threatening allergic reaction can be experienced after insulin injection. Serious insulin side effects and anaphylactic reactions are signaled by:
Rash or itching over the whole body
Swelling (edema) of the tongue, throat, arms, hands, feet, ankles or lower legs
Difficulty breathing or shortness of breath
Fast heartbeat (tachycardia) or abnormal heartbeat rhythm
Significant weight gain in a short period of time.
Gradually increasing insulin doses under medical supervision is used as a treatment to desensitize an individual with a severe insulin allergy.5,11
Side effects of insulin that are more common include:1,5,7
- Weight gain – this may happen initially when insulin therapy is started, due to correction of protein and energy metabolism.
- Lipohypertrophy – raised lumps in the skin caused by repeated injections at the same site.
Other local effects – these are less common than lipohypertrophy and include infection, injection site abscess.
Human insulin inhalation powder (Afrezza) became available by prescription
Afrezza is a rapid-acting, dry-powder formulation of recombinant human insulin may be used in the treatment of adults with type 1 or type 2 diabetes. In patients with type 1 diabetes, the drug must be used in combination with long-acting insulin.
A single inhalation of Afrezza is taken at the beginning of meals.
Insulin Pumps for Controlling Diabetes
Ever since the discovery of insulin and its use in treating diabetes, medical research has struggled to find a way of delivering it that accurately mimics the normal physiological action of insulin and overcomes the burden of daily injections.
The main development in this area has been the insulin pump.
Insulin pumps for type 1 diabetes
Insulin pumps – or continuous subcutaneous insulin infusion pumps – remove the daily need for multiple injections.
Instead, a cannula – a very thin and flexible plastic tube inserted under the skin using a needle – needs to be replaced every two or three days.
An insulin pump continuously releases insulin in small doses (the basal insulin) from its reservoir and can deliver an additional dose (a bolus) when needed. As a result, an insulin pump more closely mimics normal insulin physiology and offers greater accuracy than daily injections. Insulin pumps can also provide better glucose control and better HbA1c readings.