Types of insulin, storage and pumps
Insulin is a hormone produced in the pancreas. Your body uses insulin to move glucose from the bloodstream into cells where it is used as energy. When you have type 1 diabetes your body is not producing insulin so you need to administer it via injections or a pump.
Why inject insulin?
Insulin can’t be given in tablet form because stomach acids destroy insulin.
Types of insulin
There are five main types of insulin. Your healthcare team will be able to work with you to determine which combination of insulins is right for you.
- Rapid-acting insulin is injected as a bolus dose within 15 minutes before a meal with carbohydrates. The amount is adjusted according to the amount of carbohydrate you plan to eat.
- Short-acting insulin is injected as a bolus dose within 30 minutes before a meal with carbohydrates. It has a slower onset and peak action than rapid-acting insulins.
- Intermediate-acting insulin is a cloudy insulin that must be gently premixed before each use. It starts to work about 90 minutes after injecting and may last up to 24 hours.
- Long-acting insulin provides a slow release of insulin lasting between 16-24 hours. It may be injected once or twice daily at the same time each day to allow glucose stored in your body to provide slow, constant energy.
- Mixed insulin is available as two varieties:
- Rapid or Short-acting insulin mixed with an intermediate-acting insulin. These combination insulins may be used up to three times a day. This insulin is cloudy and requires premixing.
- Rapid acting insulin mixed with an Ultralong-acting insulin which is typically used once daily at a mealtime. The rapid component acts on glucose from the current meal and the ultra-long component acts on stored glucose to provide slow, constant energy. It is important to note that all other meals with carbohydrates still require additional doses of rapid-acting insulin. This insulin is clear and does not require premixing.
All insulin needs to be kept below 30°C out of the fridge and ideally between 2°C and 6°C in the fridge. Once opened, with a needle, the insulin must be used over the next 28 days. Consider a ‘wallet’ to store your insulin safely while travelling.
Disposal of sharps
Dispose of syringes and needles in an approved sharps container. These containers are available from your pharmacy, some council facilities and the Diabetes Queensland Shop. Sharps containers must be kept out of reach of children.
Whether you inject insulin using a syringe, pen or pump, you will have to learn this new skill. It’s recommended that you get specific training and support when you start insulin. Ask your GP, practice nurse, nurse practitioner or credentialled diabetes educator to help you. This may take more than one visit to ensure that you are confident with how to use insulin and how to troubleshoot. Learn new skills at diabetes workshops.
What does an insulin pump do?
An insulin pump is a small, computerised device worn outside the body, that can easily be hidden under clothing – it looks a little like a pager. The pump delivers insulin via a canula that is inserted under the skin. The canula is changed every three days.
How does it work?
An insulin pump is programmed to give a small dose of insulin continuously over 24 hours, depending on individual needs. An extra dose of insulin is programmed when meals are eaten, or when blood glucose levels are too high. An insulin pump contains only rapid-acting insulin, no long-acting insulin is used.
Insulin pumps can be used on their own or in conjunction with a compatible Continuous Glucose Monitoring (CGM) device.
How long do you wear it?
The insulin pump must be worn all the time, but can be removed for short periods for instance, when showering, swimming or playing contact sports. It must not be removed for longer than two hours.
An insulin pump may be the right choice for you if you:
- Have recurrent hypoglycaemic episodes or have lost the ability to sense a hypo
- Are not physically able to use insulin pens
- Want increased flexibility for insulin dosing
- Have unpredictable blood glucose levels
- Are planning to start a family, are pregnant or have just given birth, and want to link your pump with a CGM.Are in a private health insurance scheme
- Are under 18 years – you can apply for a government subsidy.
When you first start using a pump there will be a few adjustments to make. Dosing is different on a pump, as the amounts of insulin are often lower than you may have used previously.
Insulin products (like reusable pens, injection aids, test strips, sharps bins and pump belts) can be purchased at our online shop.