How does insulin work in our bodies?

Researchers have discovered that patients with type 1 diabetes can regain the ability to produce insulin. They showed that insulin-producing cells can recover outside the body. 

How Does Insulin Work in Our Bodies?

Hand-picked beta cells from the islets of Langerhans in the pancreas. Photo: Oskar Skog, Uppsala University.

Type 1 diabetes is a serious disease that affects many children and adolescents. The disease causes the pancreas to stop producing insulin, a hormone that regulates blood sugar levels. 

When blood sugar levels are too high, the smallest blood vessels in the body eventually become damaged. This can lead to serious health problems further down the line, including heart attacks, stroke, blindness, kidney failure and foot amputations.

Professor Knut Dahl-Jørgensen and doctoral student Lars Krogvold are leading a research project, (DiViD), in which they want to ascertain among other things whether a virus in the pancreas might cause type 1 diabetes.

They have previously discovered viruses in hormone-producing cells, the so-called islets of Langerhans, in the pancreas. Now their research has generated some new and surprising results.

How Does Insulin Work in Our Bodies?

Recover the ability to produce insulin

  • Lars Krogvold explains:
  • “We found that the insulin-producing cells still have the ability to produce insulin when they are stimulated in the lab.
  • But what’s new is our additional discovery that the cells increased their ability to produce insulin after a few days outside the body.
  • Indeed, some became roughly as good at making insulin as cells from people without diabetes.
  • Some of the hormone-producing cells in the pancreas, the beta cells, produce insulin when they are stimulated by sugar. 
  • Previous work has shown that you do not immediately lose your ability to produce insulin when you are first diagnosed with type 1 diabetes”. 

Can improve patients’ daily lives

“Our findings might mean that insulin production can be partially restored if we can find a way of stopping the disease process. The potential for insulin production is greater than previously thought.

The risk of developing health problems later on is lower for those who manage to maintain a certain level of insulin production.

Less supplementary insulin means that you will be better off as a patient”, says Krogvold.

Stimulated by sugar

The aim of the study was to determine whether beta cells still have the ability to produce insulin after the patient has been diagnosed.The researchers bathed the cells in a solution through which sugar was passed. They then measured the insulin content of this solution.

“The really exciting thing here is that insulin production increases when the cells are removed from the body and placed in an environment that is not diabetes-inducing.

That your cells produce a little insulin the day after you have been diagnosed with diabetes is not unusual.

What surprised us was that the cells increased their ability to produce insulin over time and that after a few days the level was approaching normal”, says Krogvold.

RNA sequencing

In the study the researchers collected tissue samples from the pancreases of living patients shortly after they had been diagnosed.

A technique called RNA sequencing was performed on cells from six living and two deceased donors. Sequencing is a way of mapping genes. The results were compared with cells from three healthy donors.

“A complete set of DNA is present inside all cells. DNA consists of a long series of genes, and those genes that the cell needs to use in a given process are read off to form an opposite strand called RNA. RNA can act as a recipe for proteins”.

This is a complicated process. When the cell realises that it needs to make a protein, structures called ribosomes read off the RNA. All of the necessary amino acids are then assembled to make a new protein, following the recipe contained within the RNA. Ribosomes are a complex of molecules and proteins that are found inside all cell types, and it is here that protein assembly occurs.

“RNA for all the genes involved in insulin production was found in the tissue samples. We interpret this as meaning that the cellular machinery for producing insulin is still intact. This was confirmed when we saw that the beta cells produced insulin”, concludes Krogvold.

The tissue samples were sent to Uppsala University Hospital, where the analyses were performed.

Knut Dahl-Jørgensen is a professor at the Faculty of Medicine, University of Oslo and head of the Oslo Diabetes Research Centre. Lars Krogvold is a doctoral student at the University of Oslo and a paediatrician at Oslo University Hospital.

Published Mar. 23, 2015 1:17 PM – Last modified Mar. 26, 2019 2:38 PM

Insulin | You and Your Hormones from the Society for Endocrinology

How Does Insulin Work in Our Bodies?

A person with diabetes being injected with insulin to regulate their blood sugar levels.

Insulin is a hormone made by an organ located behind the stomach called the pancreas. There are specialised areas within the pancreas called islets of Langerhans (the term insulin comes from the Latin insula that means island). The islets of Langerhans are made up of different type of cells that make hormones, the commonest ones are the beta cells, which produce insulin.

Insulin is then released from the pancreas into the bloodstream so that it can reach different parts of the body. Insulin has many effects but mainly it controls how the body uses carbohydrates found in certain types of food.

Carbohydrates  are broken down by the human body to produce a type of sugar called glucose. Glucose is the main energy source used by cells.

Insulin allows cells in the muscles, liver and fat (adipose tissue) to take up this glucose and use it as a source of energy so they can function properly. Without insulin, cells are unable to use glucose as fuel and they will start malfunctioning.

Extra glucose that is not used by the cells will be converted and stored as fat so it can be used to provide energy when glucose levels are too low. In addition, insulin has several other metabolic effects (such as stopping the breakdown of protein and fat).

How is insulin controlled?  

The main actions that insulin has are to allow glucose to enter cells to be used as energy and to maintain the amount of glucose found in the bloodstream within normal levels. The release of insulin is tightly regulated in healthy people in order to balance food intake and the metabolic needs of the body.

This is a complex process and other hormones found in the gut and pancreas also contribute to this blood glucose regulation. When we eat food, glucose is absorbed from our gut into the bloodstream, raising blood glucose levels. This rise in blood glucose causes insulin to be released from the pancreas so glucose can move inside the cells and be used.

As glucose moves inside the cells, the amount of glucose in the bloodstream returns to normal and insulin release slows down. Proteins in food and other hormones produced by the gut in response to food also stimulate insulin release.

Hormones released in times of acute stress, such as adrenaline, stop the release of insulin, leading to higher blood glucose levels to help cope with the stressful event.

Insulin works in tandem with glucagon, another hormone produced by the pancreas. While insulin's role is to lower blood sugar levels if needed, glucagon's role is to raise blood sugar levels if they fall too low. Using this system, the body ensures that the blood glucose levels remain within set limits, which allows the body to function properly.

What happens if I have too much insulin?

If a person accidentally injects more insulin than required, e.g. because they expend more energy or eat less food than they anticipated, cells will take in too much glucose from the blood.

 This leads to abnormally low blood glucose levels (called hypoglycaemia). The body reacts to hypoglycaemia by releasing stored glucose from the liver in an attempt to bring the levels back to normal.

Low glucose levels in the blood can make a person feel ill.

The body mounts an initial 'fight back' response to hypoglycaemia through a specialised set of of nerves called the sympathetic nervous system.

This causes palpitations, sweating, hunger, anxiety, tremor and pale complexion that usually warn the person about the low blood glucose level so this can be treated.

However, if the initial blood glucose level is too low or if it is not treated promptly and continues to drop, the brain will be affected too because it depends almost entirely on glucose as a source of energy to function properly. This can cause dizziness, confusion, fits and even coma in severe cases.  

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Some drugs used for people with type 2 diabetes, including sulphonylureas (e.g. gliclazide) and meglitinides (e.g. repaglinide), can also stimulate insulin production within the body and can also cause hypoglycaemia. The body responds in the same way as if excess insulin has been given by injection.

Furthermore, there is a rare tumour called an insulinoma that occurs with an incidence of 1-4 per million population. It is a tumour of the beta cells in the pancreas. Patients with this type of tumour present with symptoms of hypoglycaemia.

What happens if I have too little insulin?

People with diabetes have problems either making insulin, how that insulin works or both. The main two types of diabetes are type 1 and type 2 diabetes, although there are other more uncommon types.

People with type 1 diabetes produce very little or no insulin at all. This condition is caused when the beta cells that make insulin have been destroyed by antibodies (these are usually substances released by the body to fight against infections), hence they are unable to produce insulin.

With too little insulin, the body can no longer move glucose from the blood into the cells, causing high blood glucose levels. If the glucose level is high enough, excess glucose spills into the urine. This drags extra water into the urine causing more frequent urination and thirst. This leads to dehydration, which can cause confusion.

In addition, with too little insulin, the cells cannot take in glucose for energy and other sources of energy (such as fat and muscle) are needed to provide this energy. This makes the body tired and can cause weight loss. If this continues, patients can become very ill. This is because the body attempts to make new energy from fat and causes acids to be produced as waste products.

 Ultimately, this can lead to coma and death if medical attention is not sought. People with type 1 diabetes will need to inject insulin in order to survive.

Type 2 diabetes can be caused by two main factors and its severity will depend on how advanced it is. Firstly, the patient’s beta cells may have problems manufacturing insulin, so although some insulin is produced, it is not enough for the body’s needs.

 Secondly, the available insulin doesn’t work properly because the areas in the cell where insulin acts, called insulin receptors, become insensitive and stop responding to the insulin in the bloodstream. These receptors appear to malfunction more in people who carry excessive amount of  weight.

Some people with type 2 diabetes might initially experience very few symptoms and the raised blood glucose is only picked up when a routine blood test is arranged for another reason; other people might experience symptoms similar to those seen in patients with type 1 diabetes (thirst, frequent urination, dehydration, hunger, fatigue and weight loss).

Some patients with type 2 diabetes can control their symptoms by improving their diet and/or losing weight, some will need tablets, and others will need to inject insulin to improve blood glucose levels. See the article on diabetes mellitus for more information.

Last reviewed: Mar 2018

Insulin and glucagon: How they regulate blood sugar levels

Medically reviewed by Alan Carter, Pharm.D. — Written by Zawn Villines on March 27, 2019

The pancreas secretes insulin and glucagon. Both hormones work in balance to play a vital role in regulating blood sugar levels. If the level of one hormone is higher or lower than the ideal range, blood sugar levels may spike or drop.

Together, insulin and glucagon help maintain a state called homeostasis in which conditions inside the body remain steady. When blood sugar is too high, the pancreas secretes more insulin. When blood sugar levels drop, the pancreas releases glucagon to raise them.

This balance helps provide sufficient energy to the cells while preventing the nerve damage that can result from consistently high levels of blood sugar.

In this article, we explain the functions and processes of insulin and glucagon as well as their effects on diabetes.

The body converts the carbohydrates from food into glucose, a simple sugar that serves as a vital source of energy.

Blood sugar levels are a measure of how effectively the body uses glucose.

These vary throughout the day. However, in most instances, insulin and glucagon keep these levels within a healthy range.

When the body does not convert enough glucose, blood sugar levels remain high. Insulin helps the cells absorb glucose, reducing blood sugar and providing the cells with glucose for energy.

When blood sugar levels are too low, the pancreas releases glucagon. Glucagon instructs the liver to release stored glucose, which causes blood sugar to rise.

Islet cells in the pancreas are responsible for releasing both insulin and glucagon. The pancreas contains many clusters of these cells. There are several different types of islet cell, including beta cells, which release insulin, and alpha cells, which release glucagon.

How insulin works

The cells need glucose for energy. However, most of them are unable to use glucose without the help of insulin.

Insulin gives glucose access to the cells. It attaches to the insulin receptors on cells throughout the body, instructing the cells to open up and grant entry to glucose.

Low levels of insulin constantly circulate throughout the body. A spike in insulin signals to the liver that blood glucose is also high. The liver absorbs glucose then changes it into a storage molecule called glycogen.

When blood sugar levels drop, glucagon instructs the liver to convert the glycogen back to glucose, causing blood sugar levels to return to normal.

Insulin also supports healing after an injury by delivering amino acids to the muscles. Amino acids help build the protein that is present in muscle tissue, so when insulin levels are low, muscles may not heal properly.

How glucagon works

The liver stores glucose to power the cells during periods of low blood sugar. Skipping meals and poor nutrition can lower blood sugar. By storing glucose, the liver makes sure that blood glucose levels remain steady between meals and during sleep.

When blood glucose falls, cells in the pancreas secrete glucagon. Glucagon instructs the liver to convert glycogen to glucose, making glucose more available in the bloodstream.

From there, insulin attaches to its receptors on the body’s cells and ensures that they can absorb glucose.

Insulin and glucagon work in a cycle. Glucagon interacts with the liver to increase blood sugar, while insulin reduces blood sugar by helping the cells use glucose.

A range of factors, including insulin resistance, diabetes, and an unbalanced diet, can cause blood sugar levels to spike or plummet.

The standard measurement units for blood sugar levels are milligrams per deciliter (mg/dl). Ideal blood sugar ranges are as follows:

Timing Blood glucose level (mg/dL)
Before breakfast Person without diabetes: 100 mg/dLPerson with diabetes: 70–13
2 hours after a meal Person without diabetes: Less than 140 mg/dLPerson with diabetes: Less than 180 mg/dL
Bedtime Person without diabetes: 120 mg/dLPerson with diabetes: 90–150 mg/dL

A1C is a measurement that gives a picture of average glucose levels over an extended period. A1C readings should be under 7 percent for people with diabetes and less than 6 percent for those without diabetes.

Read more about optimal blood sugar levels by clicking here.

Insulin and glucagon do not take immediate effect, particularly in people whose blood sugar levels are extremely high or low.

High blood sugar

Share on PinterestDiabetes can cause itching.

The symptoms of high blood sugar include:

  • Urinating more often than usual: The kidneys respond to high blood sugar by trying to get rid of excess glucose.
  • Excessive thirst that accompanies frequent urination: The kidneys can cause dehydration and feelings of intense thirst when trying to regulate blood sugar.
  • Feeling excessively hungry: High blood sugar does not directly cause feelings of hunger. However, a drop in insulin often causes hunger when it accompanies high blood sugar.

Over time, extremely high blood sugar may lead to the following symptoms:

Low blood sugar

Delays between meals, poor nutrition, some diabetes medications, and certain medical conditions can cause low blood sugar.

The symptoms of low blood sugar include:

  • dizziness
  • rapid heartbeat
  • weakness
  • tingling, particularly in the tongue, lips, arms, or legs
  • hunger alongside nausea
  • fainting
  • confusion and difficulty concentrating
  • irritability

Without treatment, low blood sugar can lead to seizures or loss of consciousness.

Diabetes develops either when insulin becomes ineffective or when the body cannot produce enough of it. The disease causes problems with blood sugar regulation.

There are several different types of diabetes:

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Type 1 diabetes

Type 1 diabetes is an autoimmune condition that often presents at a young age. For this reason, it is sometimes called juvenile diabetes.

This type of diabetes involves attacks by the immune system on some of the insulin-secreting beta cells in the pancreas.

People with type 1 diabetes often experience very high blood sugar. Low insulin levels, however, mean that they cannot use much of the glucose in their blood.

Type 2 diabetes

Type 2 diabetes is the most common type of diabetes, and it usually develops due to lifestyle issues, such as being overweight.

People with type 2 diabetes have insulin resistance, which means that the cells do not respond properly when insulin instructs them to absorb glucose from the bloodstream.

Gestational diabetes

Share on PinterestDiabetes can develop in women who are pregnant.

  • Gestational diabetes is a form of diabetes that develops in some women during pregnancy.
  • When a woman is pregnant, the placenta that supports the developing baby might impair her body’s ability to use insulin.
  • The result of this is insulin resistance that triggers symptoms similar to those of type 2 diabetes.

Gestational diabetes usually goes away after the baby is born. However, it is a risk factor for the later development of type 2 diabetes.

  1. Insulin and glucagon are vital for maintaining normal ranges of blood sugar.
  2. Insulin allows the cells to absorb glucose from the blood, while glucagon triggers a release of stored glucose from the liver.
  3. Everyone who has type 1 diabetes and some people with type 2 diabetes will need to supplement their insulin and manage their blood sugar through diet and regular exercise.
  • Last medically reviewed on March 27, 2019
  • Diabetes
  • Endocrinology
  • Nutrition / Diet
  • Obesity / Weight Loss / Fitness

What is Insulin?

Insulin is a hormone made by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keeps your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia).

The cells in your body need sugar for energy. However, sugar cannot go into most of your cells directly.

After you eat food and your blood sugar level rises, cells in your pancreas (known as beta cells) are signaled to release insulin into your bloodstream.

Insulin then attaches to and signals cells to absorb sugar from the bloodstream. Insulin is often described as a “key,” which unlocks the cell to allow sugar to enter the cell and be used for energy.

If you have more sugar in your body than it needs, insulin helps store the sugar in your liver and releases it when your blood sugar level is low or if you need more sugar, such as in between meals or during physical activity. Therefore, insulin helps balance out blood sugar levels and keeps them in a normal range. As blood sugar levels rise, the pancreas secretes more insulin.

If your body does not produce enough insulin or your cells are resistant to the effects of insulin, you may develop hyperglycemia (high blood sugar), which can cause long-term complications if the blood sugar levels stay elevated for long periods of time.

Insulin Treatment for Diabetes People with type 1 diabetes cannot make insulin because the beta cells in their pancreas are damaged or destroyed. Therefore, these people will need insulin injections to allow their body to process glucose and avoid complications from hyperglycemia.

Insulin and Glucagon: How Do They Work?

Insulin and glucagon are hormones that help regulate the levels of blood glucose, or sugar, in your body. Glucose, which comes from the food you eat, moves through your bloodstream to help fuel your body.

Insulin and glucagon work together to balance your blood sugar levels, keeping them in the narrow range that your body requires. These hormones are like the yin and yang of blood glucose maintenance. Read on to learn more about how they function and what can happen when they don’t work well.

Insulin and glucagon work in what’s called a negative feedback loop. During this process, one event triggers another, which triggers another, and so on, to keep your blood sugar levels balanced.

How insulin works

During digestion, foods that contain carbohydrates are converted into glucose. Most of this glucose is sent into your bloodstream, causing a rise in blood glucose levels. This increase in blood glucose signals your pancreas to produce insulin.

The insulin tells cells throughout your body to take in glucose from your bloodstream. As the glucose moves into your cells, your blood glucose levels go down. Some cells use the glucose as energy. Other cells, such as in your liver and muscles, store any excess glucose as a substance called glycogen. Your body uses glycogen for fuel between meals.

Read more: Simple vs. complex carbs »

How glucagon works

Glucagon works to counterbalance the actions of insulin.

About four to six hours after you eat, the glucose levels in your blood decrease, triggering your pancreas to produce glucagon. This hormone signals your liver and muscle cells to change the stored glycogen back into glucose. These cells then release the glucose into your bloodstream so your other cells can use it for energy.

This whole feedback loop with insulin and glucagon is constantly in motion. It keeps your blood sugar levels from dipping too low, ensuring that your body has a steady supply of energy.

Your body’s regulation of blood glucose is an amazing metabolic feat. However, for some people, the process doesn’t work properly. Diabetes mellitus is the best known condition that causes problems with blood sugar balance.

Insulin

Insulin is a hormone which plays a key role in the regulation of blood glucose levels. A lack of insulin, or an inability to adequately respond to insulin, can each lead to the development of the symptoms of diabetes.

In addition to its role in controlling blood sugar levels, insulin is also involved in the storage of fat.

The role of insulin in the body

Insulin is a hormone which plays a number of roles in the body’s metabolism.

Insulin regulates how the body uses and stores glucose and fat. Many of the body’s cells rely on insulin to take glucose from the blood for energy.

Insulin and blood glucose levels

Insulin helps control blood glucose levels by signaling the liver and muscle and fat cells to take in glucose from the blood. Insulin therefore helps cells to take in glucose to be used for energy.

  • If the body has sufficient energy, insulin signals the liver to take up glucose and store it as glycogen.
  • The liver can store up to around 5% of its mass as glycogen.
  • Some cells in the body can take glucose from the blood without insulin, but most cells do require insulin to be present.

Insulin and type 1 diabetes

  1. In type 1 diabetes, the body produces insufficient insulin to regulate blood glucose levels.
  2. Without the presence of insulin, many of the body’s cells cannot take glucose from the blood and therefore the body uses other sources of energy.

  3. Ketones are produced by the liver as an alternative source of energy, however, high levels of the ketones can lead to a dangerous condition called ketoacidosis.

  4. People with type 1 diabetes will need to inject insulin to compensate for their body’s lack of insulin.

Insulin and type 2 diabetes

Type 2 diabetes is characterised by the body not responding effectively to insulin. This is termed insulin resistance. As a result the body is less able to take up glucose from the blood. In the earlier stages of type 2 diabetes, the body responds by producing more insulin than it would normally need to.

If type 2 diabetes develops over a number of years, the extra demands on the pancreas to produce insulin can lead to a loss of insulin producing cells (known as pancreatic beta cells) as they wear out.

Depending on their level of insulin resistance, people with type 2 diabetes  may also need to take insulin injections to manage their blood sugar levels.

Insulin and fat storage

As well as being involved in the regulation of blood glucose, insulin is also involved in how fat is used by the body. When the liver is has taken up its capacity of glycoge, insulin signals fat cells to take up glucose to be stored as triglycerides.

An additional effect of insulin is in inhibiting the breakdown of fats.

Synthetic insulin

People with type 1 diabetes and a proportion of people with type 2 diabetes will need to take exogenous insulin (insulin that is not produced by one’s own body). Insulin is usually injected but can also be delivered by an insulin pump which continually infuses insulin through the day and night.

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Synthetic insulin is made in laboratories and is the most commonly prescribed form of insulin for medication purposes. Non-synthetic animal insulin is also available in the UK if preferred.

Blood Sugar and Insulin at Work

Understanding how sugar (glucose) and insulin work in your body is the foundation for knowing how diabetes works. By knowing what can affect your blood sugar levels, you can better manage it.

The basics of high blood sugar

Diabetes is a problem with your body that causes blood sugar (also called blood glucose) levels to rise higher than normal. This is also called hyperglycemia.

When you eat, your body breaks food down into sugar and sends it into the blood. Insulin then helps move the sugar from the blood into your cells. When sugar enters your cells, it is either used as fuel for energy right away or stored for later use. In a person with diabetes, there is a problem with insulin. But, not everyone with diabetes has the same problem. 

There are different types of diabetes – type 1, type 2, and gestational diabetes. If you have diabetes—type 1, type 2, or gestational—your body either doesn't make enough insulin, can't use the insulin well, or both.

Learn more about blood sugar     Learn more about insulin

Type 1

In type 1 diabetes, your immune system mistakenly treats the beta cells in your pancreas that make insulin as foreign invaders and destroys them. This can happen over a few weeks, months, or years.

When enough beta cells are gone, your pancreas stops making insulin, or makes so little insulin that you need to take insulin to live. Type 1 diabetes develops most often in young people but can also appear in adults. 

Type 2

If you have type 2 diabetes, your body does not use insulin properly. This is called insulin resistance. At first, the beta cells make extra insulin to make up for it. But, over time your pancreas can't make enough insulin to keep your blood sugar at normal levels. Type 2 diabetes develops most often in middle-aged and older adults but can appear in young people.

Some people can manage type 2 diabetes with healthy eating and exercise. However, your doctor may need to prescribe oral medications (pills) and/or insulin to help you meet your target blood sugar levels. Diabetes is a progressive disease. Even if you don't need to treat your diabetes with medications at first, you may need to over time. 

Gestational diabetes

Gestational diabetes is diabetes that develops during pregnancy. For most women, blood sugar levels will return to normal after giving birth. And if you've had gestational diabetes, you will need to be tested regularly since you are at much higher risk for developing type 2 diabetes later in life. 

So, what affects my blood sugar levels?

It is important to understand what can make your blood sugar rise or fall, so that you can take steps to stay on target.

Things that can make blood sugar rise include:

  • A meal or snack with more food or more carbohydrates than usual
  • Inactivity
  • Side effects of medications
  • Infection or other illness
  • Changes in hormone levels, such as during menstrual periods
  • Stress

Things that can make blood sugar fall include:

  • A meal or snack with less food or fewer carbohydrates than usual
  • Extra activity
  • Side effects of other medications
  • Missing a meal or snack
  • Drinking alcoholic beverages (especially on an empty stomach)

Find out about tests for diabetes

Human Insulin Injection

Human insulin comes as a solution (liquid) and a suspension (liquid with particles that will settle on standing). to be injected subcutaneously (under the skin).

Human insulin is usually injected subcutaneously several times a day, and more than one type of insulin may be needed. Your doctor will tell you which type(s) of insulin to use, how much insulin to use, and how often to inject insulin.

Follow these directions carefully. Do not use more or less insulin or use it more often than prescribed by your doctor.

Human insulin (Myxredlin, Humulin R U-100, Novolin R) solution may also be injected intravenously (into a vein) by a doctor or nurse in a healthcare setting. A doctor or nurse will carefully monitor you for side effects.

Human insulin controls high blood sugar but does not cure diabetes. Continue to use human insulin even if you feel well. Do not stop using insulin without talking to your doctor. Do not switch to another brand or type of insulin or change the dose of any type of insulin you use without talking to your doctor.

Human insulin comes in vials, prefilled disposable dosing devices, and cartridges. The cartridges are designed to be placed in dosing pens.

Be sure you know what type of container your insulin comes in and what other supplies, such as needles, syringes, or pens, you will need to inject your medication.

Make sure that the name and letter on your insulin are exactly what your doctor prescribed.

If your human insulin comes in vials, you will need to use syringes to inject your dose. Be sure that you know whether your human insulin is U-100 or U-500 and always use a syringe marked for that type of insulin. Always use the same brand and model of needle and syringe.

Ask your doctor or pharmacist if you have questions about the type of syringe you should use. Carefully read the manufacturer's instructions to learn how to draw insulin into a syringe and inject your dose.

Ask your doctor or pharmacist if you have questions about how to inject your dose.

If your human insulin comes in cartridges, you may need to buy an insulin pen separately. Talk to your doctor or pharmacist about the type of pen you should use. Carefully read the instructions that come with your pen, and ask your doctor or pharmacist to show you how to use it.

If your human insulin comes in a disposable dosing device, read the instructions that come with the device carefully. Ask your doctor or pharmacist to show you how to use the device.

Never reuse needles or syringes and never share needles, syringes, cartridges, or pens. If you are using an insulin pen, always remove the needle right after you inject your dose. Dispose of needles and syringes in a puncture-resistant container. Ask your doctor or pharmacist how to dispose of the puncture-resistant container.

Your doctor may tell you to mix two types of insulin in the same syringe. Your doctor will tell you exactly how to draw both types of insulin into the syringe. Follow these directions carefully.

Always draw the same type of insulin into the syringe first, and always use the same brand of needles. Never mix more than one type of insulin in a syringe unless you are told to do so by your doctor.

Always look at your human insulin before you inject. If you are using a regular human insulin (Humulin R, Novolin R), the insulin should be as clear, colorless, and fluid as water. Do not use this type of insulin if it appears cloudy, thickened, or colored, or if it has solid particles.

If you are using an NPH human insulin (Humulin N, Novolin N) or a premixed insulin that contains NPH (Humulin 70/30, Novolin 70/30), the insulin should appear cloudy or milky after you mix it. Do not use these types of insulin if there are clumps in the liquid or if there are solid white particles sticking to the bottom or walls of the bottle.

Do not use any type of insulin after the expiration date printed on the bottle has passed.

Some types of human insulin must be shaken or rotated to mix before use. Ask your doctor or pharmacist if the type of insulin you are using should be mixed and how you should mix it if necessary.

Talk to your doctor or pharmacist about where on your body you should inject human insulin. You can inject your human insulin in the stomach , upper arm, upper leg, or buttocks. Do not inject human insulin into muscles, scars, or moles.

Use a different site for each injection, at least 1/2 inch (1.25 centimeters) away from the previous injection site but in the same general area (for example, the thigh).

Use all available sites in the same general area before switching to a different area (for example, the upper arm).

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