I would like to talk about my experience with insulin.
1. Not all people with type 2 diabetes will eventually need insulin. About 20% of people with type 2 diabetes will need to start insulin therapy at some point in their lives. Most people with type 2 diabetes need to use oral medications first, and insulin can only be considered when oral medications have been added to the full amount and type. Moreover, after using insulin, the original oral hypoglycemic drugs are not withdrawn, or only partially withdrawn. When using insulin, as long as the liver and kidney function is still good (blood creatinine level is in the normal range, even if the urine protein is higher), it should be used in combination with oral drugs, and the most common combination is metformin. Metformin in 70-80 years old, if it has been used and the liver and kidney function is still good, still do not need to stop the drug. But sometimes need to reduce the dose appropriately.
2. Patients who combine metformin, even if they need to use insulin, the daily dose often does not exceed 30-40 units. For people who use insulin alone, if a sufficient amount of metformin is added (1.5 g/day, divided into three times), the original dose must often be reduced by at least one-third.
3, insulin adjustment process should start low and slowly increase the amount. If the dose is increased too quickly, although the blood sugar will be lowered faster, sometimes it will easily lead to hypoglycemia, followed by dose tolerance, often resulting in rebound hyperglycemia.
4. The larger the dose of insulin, the better the effect. Do not increase the dose blindly. When the total daily amount of insulin exceeds 0.8 units per kilogram of body weight, it often cannot improve the effect of lowering sugar, but sometimes makes the blood sugar higher, interspersed with more serious hypoglycemia before meals.
5, when a single subcutaneous injection of more than 20 units of insulin, be careful to prevent hypoglycemia before the next meal.
Insulin is a double-edged sword, if used improperly, it will not only fail to lower blood sugar, but may also increase hypoglycemia, increase weight, and even increase blood pressure, leading to the occurrence or aggravation of cardiovascular and cerebrovascular disease events. It is not a hypoglycemic drug that should be used sooner or later, the earlier it is used the better or has only benefits and no disadvantages, as some people realize. Only when used properly can it be a powerful tool in our fight against diabetes. There is a need to work towards individualization and dynamics in treatment (doses need to be adjusted)