If you have been told that you have diabetes, you may be wondering, "How can I do all that I need to do?" Living with diabetes can seem like a difficult task. You may feel uneasy about giving yourself tests, medications, and injections. But you can have diabetes and still lead a normal life. The steps you take to care for yourself should become part of your daily routine. Learn these steps well--they will help you to stay healthy.

What steps do I need to take?
Your health care provider will talk to you about how to care for your health. The goal is to keep your blood glucose and fat levels as normal as you can. The steps include:

  • Giving yourself insulin injections or taking oral diabetes medications. (Your health care provider will tell you if you need to take medication.)
  • Creating and following meal plans
  • Exercising
  • Testing your blood and urine
  • Getting regular check-ups

What is insulin?
Insulin is a hormone that controls blood glucose. Some people with diabetes need to take insulin injections to control their blood glucose. Insulin must be injected to work in your body.

How does insulin work in the body?
Food is broken down into a simple sugar (called glucose) that provides the energy your body needs for daily activities. Without insulin, the glucose cannot get into the body's cells for use as energy. When glucose cannot get into the cells, blood glucose will rise. Too much glucose in the blood is called "high blood glucose," or diabetes.

Normally, insulin is released into the blood by the pancreas, an organ located behind the stomach. When a person has diabetes, little or no insulin is made, or the insulin that is made does not work right.

What are the types of insulin?
There are four major types of insulin:

  • Very rapid-acting
  • Rapid-acting
  • Intermediate-acting
  • Long-acting

There are also premixed combinations of intermediate- and rapid-acting insulins. Insulin will stay in your body for different lengths of time, depending on the type of insulin you use. Your health care provider will prescribe the insulin that is best for you. You may need to take different types of insulin.

What does insulin look like?
Very rapid and rapid-acting insulins (lispro [Humalog], regular and velosulin) are clear. The long-acting insulin glargine is clear. The intermediate and long-acting insulins (NPH, lente, ultralente, and premixed) are cloudy. Do not use your clear insulin if it has "specks" in it or if it becomes cloudy. Do not use your cloudy insulin if it has lumps in it.

What to do when buying insulin
Before you pay for your insulin at the pharmacy, always check the label to make sure it's the brand prescribed by your doctor. Using the wrong type can affect your blood glucose control. Then check the expiration date on the insulin box. The date must allow you enough time to use the whole bottle. To find out how long the medicine will last, divide the number of units in the bottle by the number of units you take each day.

How do I take the insulin?
Your health care provider will give you instructions on how to take your insulin. He or she will tell you which insulin delivery system-such as syringes, pre-filled insulin pens, pump, or jet-spray injector-is right for you. Your health care provider will describe:

  • What supplies to use
  • How to measure and mix your insulin
  • How to prepare and discard the needles and syringes
  • How to perform the injection procedure

When should I take insulin?
Follow your doctor's guidelines on when to take your insulin. The time span between your insulin injections and meals may vary, depending on the type of insulin you are taking.

If you take lispro (Humalog) insulin, you should generally take it 10 minutes before eating a meal or take it with your meal.

If you use regular or intermediate-acting insulin, you should generally take it about 1/2 hour before your meals or at bedtime. By taking your insulin 1/2 hour before meals, you are allowing your food to be absorbed at the same time that the insulin starts to work. This will help you avoid a low blood glucose reaction.

Make sure you take your insulin and eat your meals on time every day.

Where should I store insulin?
Always have two bottles of each type of insulin you take. The bottle that you are using may be stored at room temperature (between 33 and 80 degrees Fahrenheit) for 30 days. Follow these guidelines:

  • Keep insulin where it will not get too hot or too cold.
  • Keep insulin out of direct sun.
  • Store extra bottles of insulin in the refrigerator.
  • Do not allow your insulin to freeze.
  • Take your new bottle of insulin out of the refrigerator the night before you are ready to use it, so that it warms to room temperature.
  • If you are carrying your insulin, be careful not to shake it. Shaking the bottle creates air bubbles which can affect the amount of insulin you withdraw for an injection.

Where can I learn more?

American Diabetes Association
1-800-DIABETES (1-800-342-2383)
www.diabetes.org

Juvenile Diabetes Research Foundation International
1-800-533-CURE (2873)
www.jdrf.org

National Institute of Diabetes and Digestive and Kidney Diseases
www.niddk.nih.gov

Or, you can contact your local chapters of the American Diabetes Association and the Juvenile Diabetes Foundation.

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