Insulin – starting for type 2 diabetes

Most people with type 2 diabetes are able to control their blood glucose with oral diabetes medications (tablets), healthy eating and regular exercise. With time, some people with type 2 diabetes will need to also use insulin injections with their tablets.

This can improve control of blood glucose levels and reduce the risk of developing complications.

Insulin helps to move the glucose from your blood into your cells to give you energy. When you have type 2 diabetes your body has stopped making its own insulin or your body has stopped using what you make.

How often do I need to inject insulin?

You may need to inject insulin once or more each day. The time of your injection will depend on when your glucose level is highest.

Read more about the different types of insulin.

Tips for starting insulin

Starting insulin to manage type 2 diabetes may seem scary and overwhelming at first, but your GP or diabetes nurse will provide support and information to help guide you through.

Here are our tips when starting insulin for type 2 diabetes:

Monitor your blood glucose levels

Testing your blood glucose levels at home gives you useful information to monitor the effects of insulin on your blood glucose levels. Every time you measure your blood glucose, record your blood results in a diabetes diary. Some blood glucose meters may record your blood glucose levels automatically. Your diary can also help you keep track of events, such as if you had a hypo or low blood glucose, and help to decide how well you are reaching your treatment goals. When you first start insulin, you need to test your blood glucose at least 3 to 4 times a day, but once you have found the insulin dose that bests suits you, you can test less often. Read more about blood glucose testing.

Work out when to inject insulin

The time of your insulin injection depends on when your blood glucose level is highest. Most people need to have insulin at bedtime, because your body makes glucose during the night, causing your blood glucose levels to be higher in the morning when you wake. Therefore, an evening dose of insulin helps to maintain lower blood glucose levels overnight. A few people find that their blood glucose levels are highest later in the day. In these people, it's best to start insulin in the morning. Some people may need to use insulin 2 or more times a day to get better glucose control. Your doctor or nurse will help you decide on the right schedule for you. It usually takes a few weeks to get your dose and timing right.

Learn how to inject insulin

Insulin can be injected using a syringe, but most people use insulin pens. Insulin pens are similar in size and shape to a writing pen. They make measuring and injecting your insulin easier and are easy to carry around. Insulin pens are not pre-fitted with needles. A suitably sized needle has to be attached to the pen. Insulin should be injected into the fatty tissue under your skin. Your abdomen or tummy area, about 5 cm away from your belly button, is usually a good place. It is easy to reach and insulin absorbs well from this site. Read more about how to inject insulin.

Know the signs of hypoglycaemia

Hypoglycaemia or low blood glucose occurs when your blood glucose level is less than 4 mmol/l, or where symptoms of hypoglycaemia are experienced at a level close to this. Hypoglycaemia can happen quickly so it’s a good idea for you and your whānau to know what symptoms to look out for, such as:

  • blurred vision
  • dizziness
  • pale, sweaty skin
  • irritability.

It’s a good idea to carry something sugary with you in case your blood glucose levels start getting low. Jellybeans are a good, quick source of sugar. Read more about hypoglycemia.

Store and dispose of your insulin and needles safely

Insulin you are not using should be stored in the door of your fridge. You can keep the insulin you are using out of the fridge for a month, as injecting insulin at room temperature is less painful.

Never put your used needles in the rubbish bin. Your GP or diabetes nurse can give you a container to put used needles in and can organise a place where you can dispose of the container once it’s full. 

Learn more

Starting insulin for people with type 2 diabetes SafeRx, Waitematā DHB, NZ