Diabetes and Insulin Treatment

Featuring Dr. Alice Cheng, MD, FRCPC, Endocrinologist

Duration: 3 minutes, 32 seconds

So insulin is one of the options to treat diabetes, and there are many different types of insulin in order to be able to mix and match so that we can best suit the patient’s needs.

There are three broad categories of insulin, and the categories are divided based on the time/action profile, so when the insulins work. So, one category is the bolus insulin. The bolus insulin’s also known as the mealtime insulin. And as the name would suggest, it is designed as a fast insulin, so that it works at the same time as the food will. So it starts quickly, it peaks fairly quickly, and it runs away quickly, so that it matches a meal.

Another type of insulin, or the second type of insulin is a basal insulin, also known as a background insulin, meant for background. So it is a flatter, longer-acting type of insulin, so that it can serve the needs of the body all day long.

Remember that even if one has not been eating, we still need insulin, because insulin is a necessary hormone to move sugar from the blood into the cells, so that the cells can use it as energy. So therefore we also need that type of insulin.

And then the final type of insulin is called premixed. So premixed is premixed, so therefore it’s a mixture of bolus, and a basal insulin together, and it gives the advantage of convenience, because it’s one type on insulin, one injection, giving two types of insulin within it. However, you lose flexibility when one uses a premixed insulin.

So insulin is administered as an injection, and it’s administered through a very small needle, and that needle just goes just under the skin, or what we call subcutaneous. Now often when insulin is mentioned to someone they immediately picture a vial, and a syringe, and it’s often a needle that looks like the flu shot needle for example, which is the one that people are very familiar with. But it is nowhere close to that. The needle that is used is much, much smaller, much, much thinner, and shorter, and actually just goes under the skin.

The insulin itself also is not coming out of a vial, again what people tend to picture. But actually nowadays insulin looks nothing like that. Insulin is actually available as a pen device, and the insulin itself is in cartridges that could be installed into the pens, or the pens may already be prefilled, so it’s really easy to carry around.

And then the only part that needs to be added is the needle tip. Now the needle itself is actually much, much smaller than what most people imagine, and they’re also much more narrow. And then people often ask “well, does it hurt?” to actually do an insulin injection. Well if somebody is able to poke their finger to get blood to test their sugar, then they are more than able to do an insulin injection, because the insulin injection is actually less painful than poking the finger to test the blood.

So I think nowadays the administration of insulin is far simpler, people can carry it around very easily and the needle itself is much, much shorter and less painful than they ever were before.

If you’re a patient living with diabetes and interested in learning more about insulin, the best thing to do is to contact your local health care team, starting obviously with your family doctor, or a local endocrinologist, or the diabetes education team, or any other health care provider that may be available to you.

Presenter: Dr. Alice Cheng, Endocrinologist, Mississauga, ON

Local Practitioners: Endocrinologist