Managing Type 2 Diabetes mellitus

Managing Type 2 diabetes is not a fixed process. It keeps changing. At first, oral medication may be enough. Later insulin may be needed to control blood sugar levels. 

For some people with diabetes, a healthy diet and plenty of physical activity is enough to control blood glucose; for others, oral medications and injections work well. The medication that people with diabetes use to manage glucose levels depends on what they eat, their level of physical activity and their weight.

Medications to treat Type 2 diabetes help the body to produce more of its own insulin; produce a feeling of fullness after meals; and slow down the movement of food through the stomach.

Losing weight and being more active can help avoid or delay the use of insulin ―a hormone that helps to control blood glucose levels  by allowing the  body to absorb glucose from the blood. As Type 2 diabetes progresses, the person with diabetes may need to take more tablets and insulin injections. 

There are different types of insulin:  

• Short- acting human insulin
• Intermediate acting human insulin
• Premixed insulin
• Analog insulins

The number of insulin injections a day depends on personal needs. For some people with diabetes, injecting just once a day is sufficient to manage blood glucose levels but as diabetes progresses, there is a chance that this will increase.  

It is important to test blood glucose regularly when using insulin. 

Tips on choice of injection sites:  

• It is important to rotate your site to get the best benefit from the insulin. 
• Do not use the same spot on a particular site to inject insulin. Injecting the same spot can cause small hard lumps that can affect the way insulin is absorbed thus affecting blood glucose control.
• The best places to inject are the abdomen, buttocks and outer thigh as they have a layer of fat below the skin and not too many nerves. 
• Massaging the site before or after injection may speed up absorption of insulin and so, is not recommended. 
• Exercise can also increase the rate at which insulin is absorbed in the body. So, don’t inject the part you are going to exercise. If you do, wait at least 45 minutes before starting. 
• Use a new spot within a chosen site each time. Move around within the chosen site keeping at least one finger distance from the last injection.
• Move in the same direction. 

Best injection  sites

The abdomen is the best site for injecting morning and noon doses of insulin and injecting into the upper thigh at night decreases the risk of having hypos during the night.

A few points to keep in mind when using insulin:

• It can lower blood glucose levels so make sure you know what to do in case of a hypo.
• Be careful when you drive
• Control portion sizes as insulin can add on weight
• Consult your dietitian for a good diet plan and learn how to count carbs.