The Varying Insulin Needs of Patients with Diabetes
Many patients with diabetes rely on taking insulin in order to maintain healthy blood glucose levels. Some people require higher or more frequent doses of insulin than others, and the amount of insulin that a person with diabetes requires can depend on a number of factors.
What is Insulin, & Why Do We Need It?
Insulin is a hormone produced in the pancreas, which is an organ next to the stomach. Hormones are “chemical messengers” that direct the body’s cells to carry out a certain function. Insulin’s “chemical message” helps the body turn food into usable energy.
After we eat, our bodies begin to convert the food we consume into a simple sugar called glucose, which then travels throughout the body via the bloodstream. The pancreas releases insulin which tells the cells of the muscles, liver, and adipose tissue (cells that store fat) to absorb the glucose and use it for energy. When a person is diagnosed with diabetes, their body either can’t produce enough insulin, or can’t produce it at all. This means that glucose remains in the bloodstream, and the body is unable to use it for energy. Supplementing with injected insulin or with insulin from an insulin pump helps individuals with diabetes keep blood glucose levels within range.
The amount of insulin each person with diabetes needs varies from individual to individual. Some individuals need vastly greater amounts of insulin than most in order to effectively manage their blood glucose levels. If larger or more frequent doses are needed, large-capacity insulin pumps that can hold up to 480 units of insulin and can last for up to 3 days without changing the cartridge can be a helpful tool to help maintain healthy glucose levels.
The following conditions may contribute to increased insulin needs in patients with diabetes:
Low insulin sensitivity. Individuals with type 2 diabetes are insulin-resistant, meaning that their body does not respond well to the amount of insulin that the pancreas is producing. Additionally, the pancreas of someone with type 2 diabetes will produce less insulin over time – meaning that the body requires more insulin, but is naturally producing less. Though many individuals with type 2 diabetes do not take insulin, between 30 and 40% do use insulin to manage their blood sugar. These individuals may require larger doses than someone with type 1 diabetes, whose body is highly sensitive to insulin because it produces none naturally.
Being a teenager with type 1 diabetes. Growth hormone, which is responsible for the adolescent “growth spurt,” can make the body’s cells more resistant to insulin. Teens with type 1 diabetes can require up to 30-50% more insulin than an adult due to this effect.
Becoming pregnant with a previous diagnosis of diabetes. Hormones during pregnancy can have a notable effect on insulin needs, and women with a prior diabetes diagnosis will find their insulin needs changing throughout their pregnancy. Blood glucose levels may be very unstable the first 6-8 weeks, then lower than usual for the rest of the first trimester; in the second and third trimester, insulin needs tend to rise up until the 36th week.
Like many other medications, not everyone will require the same dose of insulin to effectively manage their blood sugar levels. If you have any questions about your insulin needs, it’s important to speak with a diabetes care management team.