This example above assumes that you have a constant response to insulin throughout the day. In reality, individual insulin sensitivity varies. Someone who is resistant in the morning, but sensitive at mid-day, will need to adjust the insulin-to-carbohydrate ratio at different meal times. In such a case, the background insulin dose would still be approximately 20 units; however, the breakfast insulin-to-carbohydrate ratio might be breakfast 1:8 grams, lunch 1:15 grams and dinner 1:12 grams.

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Bean tostada: Bake 1 corn tortilla in 400-degree oven until crisp. Spread with ½ c cooked or canned pinto beans (rinsed) and 2 Tbsp shredded reduced-fat Mexican blend cheese. Return to oven for 5 to 10 minutes until cheese melts. Top with ¼ c salsa. Serve with a cabbage salad (1 c shredded cabbage and 1 chopped tomato with 2 Tbsp reduced-fat dressing).

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The Mediterranean style eating pattern focuses on mostly plant-based foods like vegetables, fruit, whole grains, cereals, nuts, seeds, and beans, seasonally fresh, and locally grown foods. Olive oil is the main source of fat.  This eating pattern also includes a small amount of dairy products, such as cheese and yogurt, fish, and poultry. Red meat is limited. Wine can be consumed in small amounts (1-2 glasses of wine per day) with meals. 

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If your pancreas secretes little or no insulin (type 1 diabetes), or your body doesn't produce enough insulin or has become resistant to insulin's action (type 2 diabetes), the level of glucose in your bloodstream increases because it's unable to enter cells. Left untreated, high blood glucose can lead to complications such as blindness, nerve damage (neuropathy) and kidney damage.

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Aside from managing your diabetes, a diabetes diet offers other benefits, too. Because a diabetes diet recommends generous amounts of fruits, vegetables and fiber, following it is likely to reduce your risk of cardiovascular diseases and certain types of cancer. And consuming low-fat dairy products can reduce your risk of low bone mass in the future.

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"Patients need to know how to take their insulin properly since there are many formulations on the market, including short- and long-acting insulin and premixed," Mazhari said. "Most can be started on a long-acting insulin once a day, though for some patients short-acting or mealtime insulin may be necessary as well. Insulin doses need to be further adjusted depending on blood sugar readings."

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How it works: Helps insulin work better in muscle and fat. It lowers the amount of sugar the liver releases and makes fat cells more sensitive to insulin’s effects. It may take a few weeks for this kind of drug to lower blood sugar. Your doctor should talk with you about heart risks with this type of drug, which he may call “thiazolidinediones.” Side effects for thiazolidinediones are rare but may include:

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"Patients need to know how to take their insulin properly since there are many formulations on the market, including short- and long-acting insulin and premixed," Mazhari said. "Most can be started on a long-acting insulin once a day, though for some patients short-acting or mealtime insulin may be necessary as well. Insulin doses need to be further adjusted depending on blood sugar readings."

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If you have type 1 diabetes, insulin therapy replaces the insulin your body is unable to produce. Insulin therapy is sometimes needed for type 2 diabetes and gestational diabetes when other therapies have failed to keep blood glucose levels within the desired range. If your doctor says that you need insulin therapy, take the recommendation seriously. Insulin therapy can prevent diabetes complications by helping keep your blood sugar within your target range.

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During digestion, pancreatic beta cells release not only insulin, but in a much smaller amount, the hormone amylin, which helps mediate sharp rises in blood glucose levels following meals. Pramlintide (Symlin) is a new, synthetic form of amylin that may help improve blood glucose control for some type 1 and type 2 diabetic people who use insulin. Pramlintide has few side effects (nausea is the main one) but it adds another set of injections to a diabetic person's daily pharmaceutical routine, as it cannot be mixed in the same syringe with insulin.

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But good general advice to follow is to keep your carbs consistent -- eat the same amount at breakfast, lunch, and dinner to keep blood sugar from spiking or dipping too low. Weisenberger recommends 45 grams as a target for the three main meals of the day. "If you go lower than 30 grams at a meal, it's going to be really hard to get all the nutrients you need, such as fiber and phytochemicals," the health-boosting nutrients in fruits and vegetables. 

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“I can’t say enough about the benefits of weight training, not just for people with diabetes but for everyone,” Colberg-Ochs says. Weight training builds muscle mass, important for those with type 2 diabetes. “If you lose muscle mass, you have a lot harder time maintaining your blood sugar,” Colberg-Ochs says. Plan for resistance exercise or weight training at least twice a week as part of your diabetic management plan — three is ideal, but always schedule a rest day between weight workouts (other exercise is fine on those days). Each session should include 5 to 10 different types of lifting involving the major muscle groups. For optimal strength gains, work your way up to doing three to four sets of each exercise, with each set comprising 10 to 15 repetitions.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2019, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions.

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Bean tostada: Bake 1 corn tortilla in 400-degree oven until crisp. Spread with ½ c cooked or canned pinto beans (rinsed) and 2 Tbsp shredded reduced-fat Mexican blend cheese. Return to oven for 5 to 10 minutes until cheese melts. Top with ¼ c salsa. Serve with a cabbage salad (1 c shredded cabbage and 1 chopped tomato with 2 Tbsp reduced-fat dressing).

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A diagnosis of pre diabetes is a warning sign about your health, don’t let it become a life sentence. With the right pre-diabetes diet plan, it is reversible. Losing weight drains excess fat from the pancreas and allows for the insulin function to normalize. Irrespective of whether you lead a sedentary, moderately-active or highly-active lifestyle, we have a simple diabetic diet plan for you, which, when coupled with regular exercise, will help reverse your diabetes.

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It’s estimated that almost 50% of the American population has diabetes or prediabetes – a condition where blood sugar is higher than normal levels. It is accompanied by insulin resistance, a risk factor for full-blown diabetes, and other health complications. National Health and Nutrition Examination Survey (NHANES) data estimates the recent prevalence of total diabetes, diagnosed diabetes and undiagnosed diabetes’ US trends to be 12-14% among US adults.

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Insulin is a hormone produced by cells in the pancreas called beta cells. Insulin helps the body use blood glucose (a type of sugar) for energy. People with type 2 diabetes do not make enough insulin and/or their bodies do not respond well to it, leading to elevated blood sugar levels. Oral diabetes medications bring blood sugar levels into the normal range through a variety of ways.

During digestion, pancreatic beta cells release not only insulin, but in a much smaller amount, the hormone amylin, which helps mediate sharp rises in blood glucose levels following meals. Pramlintide (Symlin) is a new, synthetic form of amylin that may help improve blood glucose control for some type 1 and type 2 diabetic people who use insulin. Pramlintide has few side effects (nausea is the main one) but it adds another set of injections to a diabetic person's daily pharmaceutical routine, as it cannot be mixed in the same syringe with insulin.

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Do you get enough exercise? If you're like many Americans, the answer is no — and that's especially true for those of us with diabetes. Studies show as few as 39 percent of people with type 2 diabetes participate in regular physical activity, compared with 58 percent of other Americans. And that's a shame, because working out can help increase insulin action and keep blood sugars in check, says Sheri Colberg-Ochs, PhD, founder of the Diabetes Motion Academy in Santa Barbara, Califorinia, and professor emerita of exercise science at Old Dominion University in Norfolk, Virginia.

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How it works: Helps insulin work better in muscle and fat. It lowers the amount of sugar the liver releases and makes fat cells more sensitive to insulin’s effects. It may take a few weeks for these drugs to lower blood sugar. Your doctor should talk with you about heart risks with this type of drug, which he may call “thiazolidinediones.” Side effects from this type of drug are rare but may include:

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Sulfonylureasmay increase the risk of death from cardiovascular disease. Prolonged exercise and alcohol intake increase the risk for hypoglycemia. Patients undergoing surgery or who have had recent trauma, stress, or infection may need to switch from a sulfonylurea to insulin to manage blood sugar levels. People with kidney or liver disease need to take precaution.

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Insulin is a hormone that is produced naturally in our bodies. Its main role is to allow cells throughout the body to uptake glucose (sugar) and convert it into a form that can be used by these cells for energy. Without insulin, we cannot survive, and death from diabetes was a common occurrence until insulin was discovered in the early 1900s by Frederick Banting and Charles Best.

What type of insulin is used for Type 2 diabetes


Insulin is a hormone produced by cells in the pancreas called beta cells. Insulin helps the body use blood glucose (a type of sugar) for energy. People with type 2 diabetes do not make enough insulin and/or their bodies do not respond well to it, leading to elevated blood sugar levels. Oral diabetes medications bring blood sugar levels into the normal range through a variety of ways.

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"Patients need to know how to take their insulin properly since there are many formulations on the market, including short- and long-acting insulin and premixed," Mazhari said. "Most can be started on a long-acting insulin once a day, though for some patients short-acting or mealtime insulin may be necessary as well. Insulin doses need to be further adjusted depending on blood sugar readings."

Would I know if I had type 1 diabetes


High doses of insulin can lower levels of potassium. If potassium gets too low (hypokalemia), it can cause muscle aches or weakness, abnormal heart rhythms, and even death. Other side effects of insulin include break down of fat at the injection site(the injection site might be depressed or raised), and allergic reactions, which can be local or involve the entire body. The latter may be life-threatening.
Type 1 diabetes: If you have Type 1 diabetes, you must take insulin, either by injection or by insulin pump, to survive. Why? Type 1 diabetes is an autoimmune disease that destroys the beta cells in the pancreas. This means that the body can’t produce insulin (or at least enough of it). When this happens, the body literally can’t fuel itself, and it will start to use protein and fat stores for energy. This may seem OK, but blood sugar levels climb dangerously high. In addition, a serious condition called diabetic ketoacidosis (DKA) can set in, which, if not treated, can be fatal. Hopefully you can see why insulin is literally a life-saving medicine for those with Type 1 diabetes. 

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The Diabetes Plate Method is another option that uses many of the ideas from the eating patterns described above and can be a great place to start for many people with diabetes.  This method uses a 9 inch plate.  The first step for many people is to use a smaller plate than they have been eating from.  Once you have a smaller plate, the idea is to fill half your plate with non-starchy vegetables, ¼ of your plate with protein foods and the last ¼ of your plate with carbohydrate foods. 

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Some people are scared of taking insulin because it has to be injected or infused. Injections and infusions mean needles, and if you have a fear of them, it’s understandable that you’re not going to be too keen on insulin injections. (There is an inhalable insulin available, but that’s an ultra-rapid-acting insulin; a longer-acting insulin is usually needed, and that must be taken by injection.)

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Tuna melt: Top 1 toasted whole grain English muffin with ¼ c tuna mixed with 1 tsp mayonnaise (or 1 Tbsp light mayonnaise), 1 Tbsp minced dill pickle and/or chopped celery and 1 oz reduced-fat cheese. Place in pre-heated oven (450ºF) for 5 to 10 minutes (or microwave for 30 seconds until cheese melts).  Serve with 8 baby carrots with 2 Tbsp reduced fat ranch dressing, and 1 c fat-free milk or calcium-enriched soy beverage.

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In 2015, an inhaled insulin product, Afrezza, became available in the United States. Approved for adults with type 1 or type 2 diabetes, Afrezza is a rapid-acting insulin that you inhale at the beginning of each meal. It does not replace long-acting insulin, and isn't appropriate for everyone. People who smoke or have lung problems such as asthma or chronic obstructive pulmonary disease should not use Afrezza. Your doctor can help determine if Afrezza is right for you.

Healthy fats that provide Omega-3 and Omega-6 fatty acids are your friends. Not only do these fats help you feel fuller, they are heart-healthy and are beneficial for diabetics (as shown by research published in Cardiovascular Diabetology 2009). The study found that adding just 4g of prescription Omega-3 to the diet resulted in significant reductions in the levels of triglycerides, VLDL triglycerides, the triglyceride/HDL cholesterol ratio and an increase in HDL cholesterol. Think avocado, nuts, olive oil and oily fish, for example.

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People with diabetes generally rotate injection sites to prevent tissue injury and for the best insulin absorption. Insulin is absorbed most quickly when it is injected into the abdomen; the thighs and buttocks are other common injection sites. Some people with diabetes find it more convenient and comfortable to use newer insulin delivery systems, such as prefilled or cartridge pen insulin dispensers. While these eliminate the need to draw up insulin from a bottle, they may limit dosing flexibility. Still others benefit from use of insulin pumps, which deliver a continuous dose over 24 hours through an implanted catheter. Insulin pumps are more commonly used by people with type 1 diabetes.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2019, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions.

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It’s estimated that almost 50% of the American population has diabetes or prediabetes – a condition where blood sugar is higher than normal levels. It is accompanied by insulin resistance, a risk factor for full-blown diabetes, and other health complications. National Health and Nutrition Examination Survey (NHANES) data estimates the recent prevalence of total diabetes, diagnosed diabetes and undiagnosed diabetes’ US trends to be 12-14% among US adults.

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Exercise can also help people with type 2 diabetes avoid long-term complications, especially heart problems. People with diabetes are susceptible to developing blocked arteries (arteriosclerosis), which can lead to a heart attack. Exercise helps keep your heart healthy and strong. Plus, exercise helps you maintain good cholesterol—and that helps you avoid arteriosclerosis.

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Bean tostada: Bake 1 corn tortilla in 400-degree oven until crisp. Spread with ½ c cooked or canned pinto beans (rinsed) and 2 Tbsp shredded reduced-fat Mexican blend cheese. Return to oven for 5 to 10 minutes until cheese melts. Top with ¼ c salsa. Serve with a cabbage salad (1 c shredded cabbage and 1 chopped tomato with 2 Tbsp reduced-fat dressing).

What should I eat during a low blood sugar attack


High doses of insulin can lower levels of potassium. If potassium gets too low (hypokalemia), it can cause muscle aches or weakness, abnormal heart rhythms, and even death. Other side effects of insulin include break down of fat at the injection site(the injection site might be depressed or raised), and allergic reactions, which can be local or involve the entire body. The latter may be life-threatening.

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“I can’t say enough about the benefits of weight training, not just for people with diabetes but for everyone,” Colberg-Ochs says. Weight training builds muscle mass, important for those with type 2 diabetes. “If you lose muscle mass, you have a lot harder time maintaining your blood sugar,” Colberg-Ochs says. Plan for resistance exercise or weight training at least twice a week as part of your diabetic management plan — three is ideal, but always schedule a rest day between weight workouts (other exercise is fine on those days). Each session should include 5 to 10 different types of lifting involving the major muscle groups. For optimal strength gains, work your way up to doing three to four sets of each exercise, with each set comprising 10 to 15 repetitions.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2019, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions.

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The earliest oral diabetes drugs were the sulfonylureas. These work by stimulating the pancreas to produce more insulin. The oldest of these drugs still on the market is chlorpropamide (Diabinese), which has been used for more than 50 years. The second-generation sulfonylureas are taken once or twice a day. They include glipizide (Glucotrol, Glucotrol XL), glyburide (Micronase, DiaBeta, Glynase), and glimepiride (Amaryl).

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Eating more protein helps you to stay full for longer durations, lose weight and keep your blood sugar levels stable through the day. Since proteins are harder to digest than carbs, they offer sustained energy throughout the day and keep mindless snacking at bay. However, not all meats are the same. Choose lean cuts of meat that aren’t laden with animal fats. Completely eliminate processed meats like bacon, sausages, salami and other cold-cuts from your diet. Instead, focus on fresh chicken, turkey, fish and lean cuts of lamb. If you must eat red meat (we see no real reason to), limit it to no more than two servings a week.

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Swimming is another aerobic exercise — and an ideal one for people with type 2 diabetes because it doesn’t put pressure on your joints. “Being buoyed by the water is less stressful for you,” Colberg-Ochs says. Swimming also is easier on your feet than other forms of exercise, such as walking or jogging. Very often diabetes reduces blood flow to the small blood vessels of your extremities and you can lose sensation in your feet as a result. People with diabetes must avoid foot injuries, even minor cuts or blisters, because they can be slow to heal and are prone to infection. Special shoes made for use in the pool can help prevent scraped feet and lessen the risk of slipping.
Type and amount of insulin. There are several types of insulin available that vary in how quickly and how long they can control blood sugar. Frequently your doctor may recommend combining more than one type of insulin. To determine which types of insulin you need and how much you need, your doctor will consider several factors. These include the type of diabetes you have, your glucose levels, how much your blood sugar fluctuates throughout the day and your lifestyle.

The simple meals and snacks in this 7-day meal plan feature some of the best foods for diabetes: complex carbohydrates (think whole grains and fresh fruits and vegetables), lean protein and healthy fats. We limited refined carbohydrates (like white bread, white pasta and white rice) as well as added sugars, which can spike your blood sugar quickly. We've also cut back on saturated fats and sodium, as they can negatively impact your health if you eat too much. What we definitely didn't skimp on is flavor. The meals and snacks in this diet plan feature fresh ingredients and plenty of herbs and spices that add flavor without adding extra sodium. You can plan to eat well over the course of this weekly meal plan. 

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This example illustrates a method for calculating of your background/basal and bolus doses and estimated daily insulin dose when you need full insulin replacement. Bear in mind, this may be too much insulin if you are newly diagnosed or still making a lot of insulin on your own. And it may be too little if you are very resistant to the action of insulin. Talk to your provider about the best insulin dose for you as this is a general formula and may not meet your individual needs.

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Yes. When you’re exercising, your body uses more fluid to keep you cool. By the time you feel thirsty, you may already be getting dehydrated. Dehydration (not enough fluid in your body) can affect your blood sugar level. Drink plenty of fluid before, during, and after exercise. Make sure you are drinking water or sugar-free drinks so you aren’t raising your sugar levels.

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Exercise also helps you lose weight and improve balance, which is important because many people with type 2 diabetes are at risk for obesity and for falls. “I fully recommend that anyone over 40 with diabetes include balance training as part of their weekly routine, at least two to three days per week,” says Dr. Colberg-Ochs. “It can be as simple as practicing balancing on one leg at a time, or more complex — like tai chi exercises. Lower body and core resistance exercises also double as balance training.”

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Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Insulin Therapy, take our self assessment quiz when you have completed this section.  The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information.

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Opened and in-use cartridges and vials are fine to keep at room temperature (59 to 77 degrees Fahrenheit [15-25 degrees Celcius]) for up to 28 days. The exception is Tresiba which, once in use, is stable for up to 8 weeks at room temperature. If you are going out in the sun, always use an insulated bag protected by a cool pack to ensure your insulin doesn't heat up; but avoid freezing it. During cold weather, keep your insulin supplies close to your skin so your body heat keeps them at a more even temperature.


Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 July 2019), Cerner Multum™ (updated 1 July 2019), Wolters Kluwer™ (updated 29 June 2019) and others.

What should diabetics soak their feet in

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