Endocrinology-Diabetes Questions Insulin

Can I take Insulin to control blood sugar?

I am a diabetic with my sugar levels going up to 280 after lunch. I am taking my regular diabetes medications. Should I switch to insulin to bring down the sugar levels or is that only recommended for higher blood sugar levels?

6 Answers

This is a complex question and depends on how much insulin you make internally. It would require your md or endocrinologist to measure your insulin production and consider your options. I would NOT use insulin without a professional review as it is potentially dangerous.
Great question. The fact you know what your sugars are doing after lunch is great! Way to be checking and keep that up!

There are a ton of medications for diabetes that can help prevent blood sugar elevations for meals. This is the most common issue I see for diabetics. There is an insulin resistance that we need to overcome at meal time.

Medications designed to make you MAKE MORE INSULIN can sometimes help. These are glyburide, glipizide, glimepiride, Januvia, Onglyza, Tradjenta, Byetta, Bydureon, Trulicity, Tanzeum, Victoza. If these medications are not effective in reducing the sugar levels for meals, then we often recommend using a fast-acting insulin to cover that meal.

Just because the level is 280 doesn't mean you NEED insulin. If the sugar value comes down within a few hours with pills or other medication, then you're fine.

Many factors help me determine need for mealtime insulin. The average blood sugar values, hemoglobin A1c value > goal, current medications, duration of diabetes, weight, etc.

Diabetes is not a one-size-fits-all. I like to use combinations of medications to suit patient preference and lifestyle.

Reduce carbohydrates during lunch, go for a 20-30 min walk if still high. Yes, I would recommend insulin.
Your need for insulin should be based on overall control over time. Insulin is typically recommended for type 2 diabetics when the A1C reaches 9. This is a 90 day average of blood glucose. Insulin is also used if blood glucose needs to be controlled very quickly, for example if the patient is needing surgery or is pregnant.
It is better to start taking insulin as your blood glucose is taking longer to come down (meaning, your pancreas is weak). You may need only 3-4 units of short acting insulin premeal to help with this. You may also try avoiding fatty foods for a week or so and see if sugars are better, before trying the insulin - in which case, all you have to do is to avoid fat in meals.

Dr Sunil
It is difficult to answer this without more information. What medicine are you taking now, dosage, timing, etc., and what are your other blood sugar values? You gave only after lunch. Here is a general answer only: Blood sugars need to be controlled and there is no value at which you start a given drug. 280 after lunch is way too high and something should be done to bring it down. If that something is insulin, then so be it. Fasting blood glucose should be below 110 and never over 120. After meals should be below 140 and never exceeding 180. What is your HbA1c? It should be below 7%. If not at these levels and are on several oral agents at max doses, the insulin is needed. With this high of a post meal BS, I would go to a 4 dose insulin schedule of a long acting insulin at bed time and a short acting insulin with each meal and stop all oral agents except metformin.