What is Type 2 Diabetes?
Type 2 Diabetes is a long-term condition in which the body does not use insulin properly or does not produce enough insulin. Insulin, a hormone, helps move glucose (sugar) from the blood into the cells for energy.
When insulin does not work efficiently, cells cannot absorb the glucose in the blood. The high blood sugar levels can lead to severe health problems affecting the heart, kidneys, eyes, and nerves.
Its common features are:
It usually develops in adults, but it can occur at any age.
It is often associated with obesity, lack of physical activity, and poor diet.
It develops gradually and may not show symptoms in the early stages.
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Why is Insulin Needed for Type 2 Diabetes?
In some people with Type II diabetes, the body is unable to make enough insulin or to use it properly. Due to this, sugar stays in the blood, which can damage vital organs over time.
Insulin helps move sugar from the blood into the cells, where it is used for energy. It works to lower sugar levels to a safer range quickly.
You may need insulin if:
Blood sugar remains high despite taking tablets.
You are pregnant and have Type 2 diabetes.
You experience unexplained weight loss due to sugar loss in urine.
You are undergoing surgery or dealing with a severe illness.
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How Do Doctors Decide on Insulin Dosage?
There’s no one-size-fits-all answer. Every person is different, and the doctor decides on the dosage based on age, weight, eating habits, and sugar readings.
Doctors usually check:
1
Body weightDosage often starts at 0.1 to 0.2 units per kg.
2
Meal patternThe number of meals and snacks you consume.
3
Fasting sugar levelsTo adjust the morning dose.
4
Post-meal sugarTo change the night or mealtime dose.
The insulin dose is not fixed and may be adjusted as your health condition changes.
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What are the Types of Insulin Used in Type 2 Diabetes?
Different types of insulin work at different speeds and last for different durations. In many cases, doctors prescribe a combination based on individual needs.
1
Rapid-actingBegins working in 15 minutes, lasts 3–4 hours.
2
Short-actingStarts in 30 minutes, works for 6–8 hours.
3
Intermediate-actingStarts in 1–2 hours, lasts for 12–16 hours.
4
Long-actingWorks steadily for 24 hours or more.
5
Premixed insulinA combination of fast and intermediate types.
The choice of insulin depends on your meal timings, lifestyle, and overall health. Your doctor will select the most suitable type for your routine.
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What is the Starting Dose of Insulin for Type 2 Diabetes?
Generally, doctors prefer giving a low insulin dose so that the blood sugar doesn't drop quickly. A common guideline is 0.1 to 0.2 units per kilogram of body weight. Say, if a person weighs 60 kg, the initial dose may be between 6 to 12 units.
There are different starting approaches:
Once daily (basal insulin): Usually given at bedtime.
Twice daily (premix insulin): Given in the morning and evening.
Mealtime insulin: Used before meals, if necessary.
Physicians often begin with once-daily insulin and adjust the plan based on blood sugar response.
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How are Insulin Doses Adjusted?
Once an insulin therapy starts, a patient's blood sugar level is constantly monitored by the doctor. Thereafter, it is adjusted as needed to maintain safe and effective control.
Adjustments are usually based on:
Fasting blood sugar: Night dose may be increased if morning sugar is high.
Post-meal sugar: If the sugar level is found to be rising after a meal, mealtime insulin may be added.
Low sugar symptoms: The Dose may be reduced to avoid hypoglycaemia.
Doctors make changes slowly, usually increasing by 2–4 units at a time. This allows your body to adjust safely and reduces the risk of sudden sugar drops.
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How Many Units of Insulin Dosage are Needed Per Day for Type 2 Diabetes?
The daily insulin requirement varies from person to person. Some individuals may need around 10 units per day, while others may require 40–60 units or more. The exact dose depends on factors such as blood sugar control, body weight, diet, and physical activity.
Typical daily dose guide:
Mild cases: 0.2 to 0.4 units/kg/day.
Moderate cases: 0.5 to 0.7 units/kg/day.
Severe cases: Up to 1 unit/kg/day.
Doctors may divide the total daily dose into 2–3 injections based on meals and blood sugar levels.
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What are the Side Effects of Insulin Dosages for Type 2 Diabetes?
Insulin is effective in managing Type 2 diabetes, but like any medication, it may cause side effects if not used properly.
Common side effects include:
1
Low blood sugar (hypoglycaemia)May cause shakiness, hunger, or dizziness.
2
Weight gainSometimes occurs due to improved sugar control and increased food intake.
3
Skin lumpsThey can form if injections are given repeatedly at the same site.
4
Allergic reaction (rare)May appear as redness or rash at the injection site.
These side effects are often manageable by regular blood sugar checks, proper injection techniques, and a balanced diet.
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Can Tablets be Taken Along with Insulin for Type 2 Diabetes?
Yes, tablets can be taken with insulin for Type 2 diabetes. Medicines like metformin may still be effective even after insulin is started. Doctors often continue them to help lower the required insulin dose.
Benefits of using both tablets and insulin:
Improved blood sugar control.
Lower daily insulin requirement.
Reduced weight gain risk.
However, this decision must be made by your doctor. Do not start or stop any medicine without medical advice.
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What is the Best Time to Take Insulin?
The timing of insulin administration depends on its type. Some insulins work quickly, while others take longer to take effect. Administering insulin at the wrong time can lead to fluctuating blood sugar levels.
General time guide:
1
Rapid insulin15 minutes before meals.
2
Short-acting30 minutes before meals.
3
IntermediateBefore breakfast and dinner.
4
Long-actingAt bedtime or at the same time daily.
It is extremely important to follow your doctor’s instructions carefully. Consistency plays a critical role in managing blood sugar levels. Never skip a dose.
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What Happens if You Miss an Insulin Dose?
Missing an insulin dose can result in high blood sugar levels. This may lead to symptoms such as fatigue, increased thirst, or frequent urination. If this continues over time, it can negatively affect vital organs like your kidneys, heart, and eyes.
What to do if you miss a dose:
If it's just a few hours late, take it right away.
If it is too late, skip and wait for the next dose.
Never double the dose to make up for a missed one.
If you often forget doses, consult your doctor. They may suggest an alternative insulin plan or a reminder strategy.
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Do Patients Have to Use Insulin Forever in Type 2 Diabetes?
Not necessarily. Some individuals may only require insulin during periods of stress, illness, or surgery. Others may be able to stop using insulin if they successfully lose weight, improve their diet, and maintain an active lifestyle. However, some patients may need insulin for life.
Insulin may be stopped if:
Weight is reduced.
Diet control is substantial.
The doctor agrees that sugar is in a safe range.
Even if insulin is stopped, it is crucial to continue regular blood sugar monitoring.
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FAQs

  • Q1. Do people with Type 2 diabetes need insulin?

    Ans: Yes, many people with Type 2 diabetes may need insulin if diet, exercise, or tablets can't control their blood sugar level.
  • Q2. Is the insulin dose the same for everyone?

    Ans: No, the dose is different for each person. It depends on age, weight, lifestyle, and blood sugar levels.
  • Q3. Can insulin be started with a small dose?

    Ans: Yes, doctors often begin with a small dose and slowly increase it based on the sugar reading.
  • Q4. Do insulin doses change over time?

    Ans: Yes, doses may change based on diet, activity, stress, or illness. Regular checks help adjust it properly.
  • Q5. Can skipping meals affect insulin dosage?

    Ans: Yes, skipping meals while taking insulin can lower blood sugar too much and may cause weakness or fainting.
  • Q6. Is it safe to adjust insulin without asking a doctor?

    Ans: No, you should never change your dose without a doctor’s advice. It can be risky.
  • Q7. Does insulin always mean daily injections?

    Ans: Yes, most people take it as daily injections. Some may need it once, others multiple times a day.
  • Q8. Can lifestyle changes reduce the insulin dose?

    Ans: Yes, exercising regularly and eating healthy can help lower the dose or even stop insulin in some cases.
  • Q9. Is insulin used together with diabetes tablets?

    Ans: Doctors may give insulin with tablets to control sugar better when tablets alone are insufficient.
  • Q10. Can a health insurance policy cover insulin costs?

    Ans: Many health insurance plans cover insulin, doctor visits, tests, and diabetes-related care.