Pills or insulin | What’s better | Calculation formula | Application of the formula | How does it work
Hello dear readers! Insulin therapy is an integral part of the treatment of type 1 diabetes mellitus and complex type 2 diabetes.
By administering this hormone, we try to mimic the natural secretion of insulin.
But quite often difficulties arise with the correct selection of the dosage. And insulin in diabetes is very serious. With an overdose of this hormone, hypoglycemia occurs, if less is administered, hyperglycemia. That is, the blood sugar level is increased or decreased. And this all affects the development of complications.
So how can one correctly calculate the hormone administered? Which is better? And what is the mode of administration? You will find out about this by reading this article!
Pills or insulin?
First, let’s figure out when it is necessary to switch from pills to insulin administration for type 2 diabetes and why it is needed.
A temporary transition is possible in case of serious diseases: heart attack, acute pneumonia, intestinal infection, before or after surgery.
That is, during periods when it is necessary to constantly “monitor” the glucose level to restore the body.
Why is this done? A serious illness in any person’s body raises the level of insulin requirements. For a patient with type 2 diabetes, the “reserve” of the hormone may not be enough to meet the need against the background of stress and it is transferred to artificial administration. After recovery, the patient will be able to take pills again.
Continuous insulin therapy is prescribed when taking the pills does not help keep blood sugar levels normal. When sensitivity to oral medication decreases. This usually occurs after 5 years of the disease with poor compensation.
What’s better?
Pills or insulin — which is better? Of course, this is decided by the doctor on an individual basis. Is there any harm from it? Note that insulin has no side effects, apart from hypoglycemia — a condition where blood sugar drops below normal.
How often do you need injections? Short must be set every time you decide to eat — for food. Prolonged — once or twice a day, depending on the effect of the drug.
Calculation formula
To select the required dosage of the drug, pay attention to such points as:
- the patient’s weight;
- blood sugar indicators on an empty stomach and after meals;
- level of physical activity.
The dosage of the hormone is not randomly chosen and is not the same for all diabetics! The doctor individually prescribes a suitable dosage to avoid negative consequences.
For correction, the total daily insulin dose is determined, which includes bolus and basal insulin.
Application of the formula
The 500 rule means how many carbohydrates the body will absorb per unit of short insulin. This figure is a constant derived from years of research.
Usually, 12 grams of carbohydrates are taken for 1 XE. And to determine the dosage for 1 XE — 12 is divided by the rule of 500.
For example: a person needs 30 units of short insulin and 30 basal insulin per day, which means SDI = 60, we calculate UK = 12: (500: 60) = 12: 8.3 = 1.4 units per 1 XE.
How does it work in practice?
To understand how it works in practice, it is necessary to remember that insulin requirements change during the day. Usually, the protocol is as follows, for breakfast the need is high, for lunch — average, for dinner — the lowest and the minimum dose is set.
Based on the daily insulin requirement and based on the carbohydrate ratio, you can more accurately select the dosage. Therefore, it is necessary to control sugar before and after meals, after 2 hours. Sugar before meals should be no more than 6.5, and after 2 hours — no more than 7.8. And, by the next meal, drop to 6.5 mmol / l.
If the sugar value is below 6.5, then there was an overdose of the hormone and it must be reduced. If it is higher than the initial value, it is necessary to increase the carbohydrate ratio. Accordingly, if the blood pressure remains at the same level, the insulin dose is not reduced.
“Long acting” insulins are best injected under the skin of the thigh or buttocks. Short-acting — in the abdomen or arms.
What is the best baseline insulin? The one that makes perfect compensation. It can be Levemir, Lantus, etc.