Stephen J. Schueler, M.D.

Diabetes Adult Onset Insulin

Insulin therapy is the primary treatment for type 1 diabetes. It may also be used in type 2 diabetes when blood sugar levels cannot be adequately controlled with oral medications.

Insulin reduces sugar levels in the bloodstream by stimulating the body to utilize glucose for energy. Insulin is given by injection, or through an automatic insulin pump. Both methods require regular blood sugar measurements, in order to monitor therapy.

Insulin pumps are small devices that that deliver insulin through a tiny needle placed in the skin. This provides a constant dose of short-acting insulin at all times. The pump can be adjusted to release extra insulin before a meal.

Insulin injection therapy involves injections of short, intermediate, or long-acting insulin, at different times of the day. Insulin injections may be given 2 to 4 times per day. Insulin doses vary, depending on a person's size, blood sugar level, caloric intake and activity.

A sliding scale is an individualized program that allows short-acting insulin to be given when blood sugar levels become too high. Such a program can be individualized for each person.

Example of Sliding Scale Insulin Dosing

Glucose ReadingRegular Insulin Dosing
140 - 1602 units, re-check glucose in 2 hrs
200 - 2404 units, re-check glucose in 2 hrs
240 - 3006 units, re-check glucose in 2 hrs
300 - 4008 units, re-check glucose in 2 hrs
400 - 50010 units, re-check glucose in 2 hrs
> 500See doctor now!

Check with your doctor for specific adjustments in sliding scale doses. Your sliding scale dose will vary with your weight, diet, level of activity, and sensitivity to insulin.

Continue to Diabetes Adult Onset Meglitinides

Last Updated: Oct 5, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Diabetes Adult Onset References
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  2. Lebovitz HE. Type 2 diabetes: an overview. Clin Chem. 1999 Aug;45(8 Pt 2):1339-45. [10430816]
  3. Nagaya T, Yoshida H, Takahashi H, Kawai M. Increases in body mass index, even within non-obese levels, raise the risk for Type 2 diabetes mellitus: a follow-up study in a Japanese population. Diabet Med. 2005 Aug;22(8):1107-11. [16026381]
  4. Patja K, Jousilahti P, Hu G, Valle T, Qiao Q, Tuomilehto J. Effects of smoking, obesity and physical activity on the risk of type 2 diabetes in middle-aged Finnish men and women. J Intern Med. 2005 Oct;258(4):356-62. [16164575]
  5. Ratner RE. Type 2 diabetes mellitus: the grand overview. Diabet Med. 1998;15 Suppl 4:S4-7. [9868984]
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