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How to adjust the dosage and variety of insulin?

Some people with diabetes have great expectations for insulin, looking forward to supplementing insulin one time or give themselves a little more insulin every time when they know the treatment effect and non-toxic effect of insulin. And herein it is necessary to warn people with diabetes seriously, it can be very dangerous, excessive injection of insulin is more likely to induce hypoglycemia (low blood sugar), there will be serious life-threatening.

People with diabetes should pay attention to insulin injection, which is no laughing matter, it is highly undesirable for some people with diabetes who wonder one pace to reach the designated position. Each person's condition is different, the dosage form of insulin, types, the number of injections have to go through a period of time to identify the most suitable programs for people with diabetes’ own conditions, which need to be adjusted continuously in the period.

Dose adjustment of insulin
Generally, the initial dose of insulin should be smaller than the actual needs of people with diabetes, so as to avoid the occurrence of hypoglycemia (low blood sugar). At the beginning, the dosage of insulin injection is required to be increased gradually, but avoid too frequent dose modification. Adjust once every three or four days, increase or decrease range of 2-4U is appropriate every time, until reaching the goal of blood glucose control. Pay much attention to dose adjustment, dose adjustment interval should be extended afterwards and accompanied with further reduced range of adjustment; meanwhile, the insulin dose, diet, and exercise should be maintained in a relatively dynamic equilibrium state. Under normal circumstance, specific method for insulin injection is: select the maximum dose before breakfast, followed by the dose before dinner, less dosage before lunch, and the dose is minimal when there is a need to take an injection before sleep.

There are also some considerations that should be taken when adjusting the dose of insulin for injection. For example, diet and physical activity should be adjusted until the blood glucose is stabilized, afterwards, the adjustment of insulin dose will be suitable. Meanwhile, after each adjustment, there should be a period under observation that usually last for 3 to 5 days, it is appropriate and safe to make another adjustment when blood glucose and urine glucose are stabilized; or the observation period should be extended to avoid hypoglycemia (low blood sugar) if there is an decreased trend of blood glucose and urine glucose.

In addition, the dose of insulin can be increased appropriately when there is a poor control of blood glucose. For example, increased dose of insulin can be added for injection before dinner when there is a poor blood glucose control in the morning (Fasting blood glucose); furthermore, the dose of short-acting insulin should be increased before breakfast when there is a poor blood glucose control after breakfast and / or before lunch. Notably, the specific dose adjustment should be performed according to the specific judgment of doctors. When the people with diabetes cannot ensure whether or not or how much should they add, a sensible suggestion will be that people with diabetes can ask their doctor when they have a problem with blood glucose control.

Some people with diabetes say that there are problems with the insulin varieties to cause a poor blood glucose control, and they want to change the variety. Typically in a situation like this, I will always ask the people with diabetes first to confirm whether there is a problem with the way insulin is used or not, because the key to the success of insulin treatment lies in the use of skills, insulin varieties are generally not a interference factor. Therefore, when there is an imperfect outcome of insulin therapy, the impact of other factors and injection skills improvement should be the first considered. If there is no problem in these aspects, changing the type of insulin preparation should be taken into account in the next place.

Some people with diabetes will appear allergy, resistance or poor efficacy on the low quality of insulin, the replacement of insulin formulations should be required under such circumstance. In general, it is changed from normal insulin to high purity products, and from pig insulin to human insulin. How to replace also depends on the situation, usually for the same dose of insulin with higher quality, and the people with diabetes’s condition will be better in most cases. However, there are some other people with diabetes who only have a allergy on the low quality of insulin, then the dose of insulin should be reduced after replacement.

The number of insulin injections is not complex, short-acting insulin injections should be applied in most cases at their beginning of using insulin, then switch to or with the medium-acting insulin when satisfied with the use of short-acting insulin, or combine short-acting insulin with long-acting insulin.

Because many people with diabetes need to work, it is not easy and inconvenient to inject at noon, they can take an injection of insulin in the morning putting the dose of insulin before breakfast and lunch together, but the specific situation depends on the consultation with the doctor, do not try to invent something by oneself. There are some people with diabetes who hold the luck psychology and unauthorized adjust the dose of insulin, some problems occur in the end. Be sure to keep these in mind: communicate with doctors in a timely manner before the adjustment of insulin dose, and do not take matters into your hands.

See also:
item Principles of the Treatment of Diabetes
item Five Contraindications for Diabetes
item Insulin:

item Hypoglycemic drugs:

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