After you have been on 3-4 non insulin medications, and you are not controlled, then it’s probably time to start insulin. Which type of insulin should you start. The short answer is a long acting insulin.
It’s super easy. It’s just one shot a day. The insulin lasts 24 hours and smooth and you don’t have to worry about eating right away or panicking about lows. It’s very well tolerated and simple to teach by the staff and easy to understand by the patient.
You usually start with 10-12 units a day and titrate up according to your fasting sugars. Different doctors will have different goals for your fasting sugars, but it’s somewhere under 100 or under120, some maybe higher, just depends. Also, the amount of insulin that you increase or decrease varies depending on the physician and patient. But, it’s usually 2-3 units every 3-5 days.
You should not vary the insulin on a daily basis. Some patients will take more or less everyday depending on what their sugars are at the time they give it. For example, if they are due for their 20 units, they will give them selves just 10 because their sugar was 85 because they worry about getting lows. Also, they will give more if their sugars are higher than expected. This is not the way the insulin is supposed to be taken. Please stop doing this!
Stick to the same dose everyday and once you found that dose that keeps your sugars in the 80-120 range or other range that your doctor has told you to be in.