Insulin is a hormone that is important in the body’s regulation of blood sugar levels and other processes. People with diabetes either have no insulin or have low insulin levels. This means that their body is unable to absorb glucose in the right way.
After people eat, beta cells in the pancreas create insulin and release it into the bloodstream. Insulin helps body cells to consume sugar from food, such as muscle , fat and heart cells, and use it for energy and other important processes.
When a person eats, all the energy they get from a meal is not immediately used by them. Insulin helps the body store glucose as glycogen in the liver. When the levels of blood sugar are poor, or when a person needs more energy, the liver releases it.
In order to control blood sugar, insulin is necessary to ensure that levels stay within certain limits and to stop them from rising too high or dropping too low.
A person’s beta cells do not contain insulin for type 1 diabetes. Type-1 diabetes was a deadly disease in the past.
It became possible for individuals with diabetes to live complete and productive lives after scientists learned how to use insulin to treat diabetes.
The person, however, requires the right amount of extra insulin to have the best effect. Over time and between individuals, the amount can vary.
The American Diabetes Association ( ADA) states that the risk of complications for individuals with type 1 diabetes can be minimized by diligent blood glucose control.
In order to change their insulin dose to remain healthy, this article looks at ways to determine how much extra insulin a person with type 1 diabetes needs. It also explores ways to regulate the levels of blood glucose when a person has type 2 diabetes.
What is insulin sensitivity factor?
To remain healthy, a person with diabetes needs to keep their blood sugar levels within a target range. Insulin may avoid an increase in blood sugar levels to dangerously high levels.
Their blood sugar levels drops when a person takes insulin. If blood sugar levels drop too high, however, this can be dangerous, too.
Insulin sensitivity or correction factor refers to the amount of milligrams per deciliter ( mg / dL) in which blood sugar levels decrease when 1 unit of insulin is taken by a person.
This number can be used by a person with type 1 diabetes when determining how much insulin they need to keep their blood sugar levels within the target range.
Typically, they apply this amount to their current dose of premeal insulin. Compared to their target, the amount would depend on how much higher the blood sugar level of the individual is.
To correct their personal target blood sugar levels, a person will work with their physician.
The goal level should be as similar as possible to the levels that a person without diabetes will have, according to the ADA.
These are:
- Between 70–130 mg/dL before a meal
- No higher than 180 mg/dL up to 2 hours after a meal
Insulin treatment plans vary, but most people with type 1 diabetes now use two types of insulin:
- Basal insulin, a longer-acting form that keeps blood sugar levels stable between meals and when sleeping.
- Bolus insulin, a faster-acting form to regulate levels around mealtimes.
An insulin pump is used by some people. The pump delivers an amount of fast-acting insulin throughout the day and night and another amount of insulin for mealtimes.
The 1800 rule and calculation
A measurement can be used by individuals who use this form of pump to figure out how much rapid-acting insulin they need to lower blood sugar by a certain amount.
When using an insulin pump, the ADA provides complete guidance to determine how much insulin a person requires. With the assistance of their healthcare provider, the individual should measure this.
- The person should identify how much insulin they need by finding the average amount they use over several days. The amount may depend on the type of insulin the person uses.
- They should then divide the total so that the basal insulin is 40–50 percent of the total amount and the bolus amount is 50–60 percent.
- Next, they will divide the total by 24 to find out how much basal insulin they need each hour.
- Next, they should adjust the hourly amount, depending on activity levels and food consumption during the day.
- After that, the person should use something called the “500 rule” to find out how many carbs 1 g of insulin will cover. This will tell them how much bolus insulin they need to cover the number of carbs they plan to eat.
- Finally, they will use the 1800 (or 1500) rule to find out how much insulin they need to correct high blood glucose. This rule works by dividing the number 1,800 by the total average daily dose of fast-acting insulin to see how much one unit of insulin will lower their blood sugar levels.
Finally, prior to making any adjustments, particularly for a child or a person with a recent diagnosis, the person should discuss the outcomes with their healthcare provider.
It may be risky to change a dosage incorrectly.
What is the 1800 rule?
For example , if a person takes a total of 30 rapid-acting insulin units during the day, they can measure as follows:
- They divide 30 into 1,800.
- This gives an insulin sensitivity factor of 60.
This implies that 1 unit of fast-acting insulin will reduce the blood sugar levels of this person by 60 mg / dl.
Imagine that the goal objective of a person is to have their glucose before meals at 100 mg / dL, but their real glucose before meals is 220 mg / dL. Like this, the person will calculate:
- 220–100=120
- 120/60 is 2
To their insulin level for that meal, they can add 2 units of fast-acting insulin.
For regular insulin, instead of 1,800, the person would be divided into 1,500. However, nowadays, most individuals do not use this form of insulin.
How to test for insulin sensitivity factor
A person should test their insulin sensitivity factor every day.
To do this, they will:
- Check and record their blood sugar levels.
- Take a correction dose of insulin, based on their current sensitivity factor.
- Retest their blood sugar levels 2 and 3 hours after taking the insulin dose.
If the ratio is correct, the blood sugar level of the person should be within a 40-point range of their target.
They may need to adjust their correction factor if it is out of this range on two or more occasions. The person should talk about this with their doctor. To confirm the results, they may need further testing.
If blood sugar levels drop below 70 mg / dL, the person should, for example, stop the evaluation and treat their low blood sugar by eating or drinking something.
Before taking further action, someone who feels they need to change their insulin sensitivity factor should talk to a healthcare provider.
When to test for insulin sensitivity factor
During the day, several factors can impact the insulin sensitivity factor, so it is necessary to choose the correct time of day for testing.
Doctors suggest that the insulin sensitivity factor be tested if:
- Glucose testing shows that blood sugar levels are at least 50 mg/dL above target.
- The person has not eaten for at least 4 hours.
- They will not eat for the next 4 hours.
- They have not taken a bolus insulin dose for at least 4 hours.
People should not test for insulin sensitivity factor:
- after strong physical activity
- during an illness or infection
- after a period of low blood sugar levels
- during times of emotional stress
How diabetes type 1 and 2 affect insulin
In different ways, the two primary forms of diabetes affect insulin.
Type 1 diabetes
The body of a person with type 1 diabetes is unable to produce the insulin that the individual requires to manage their blood sugar levels.
It is unclear precisely why this occurs, but it may be because the individual’s immune system unintentionally attacks and kills the insulin-producing beta cells in the pancreas.
Approximately 5 percent of people with diabetes have type 1 diabetes, according to the ADA. It can occur at any age, but in childhood or young adulthood, it typically develops.
Type 1 diabetes signs tend to develop earlier than other forms of diabetes, as more and more beta-producing insulin cells stop functioning.
The symptoms include:
To control their blood sugar levels, people with type 1 diabetes need to take insulin every day, because their body does not naturally produce insulin.
Using a syringe or a continuous-release insulin pump, they will administer insulin. For key body functions, insulin is necessary, so the person will need regular injections for life.
Type 2 diabetes
Type 2 diabetes is a metabolic disorder in which the body often has:
- can not produce enough insulin
- can not use the insulin it produces effectively
When the body does not efficiently use the insulin it makes, this is called insulin resistance.
About 90-95 percent of people with diabetes have type 2, according to the Centers for Disease Control and Prevention ( CDC).
Risk factors for type 2 diabetes include:
- having excess weight
- being aged 45 years or over
- doing physical activity less than three times a week
- having a family member with type 2 diabetes
- having high blood pressure, high levels of triglyceride (fat) in the blood, or high overall cholesterol levels
Doctors advise people with type 2 diabetes to manage their blood sugar through:
- a healthful diet
- regular exercise
- maintaining a healthy weight
- medications, if necessary, to keep glucose levels within target
There is a fair possibility that if a person has a diagnosis in the early stages, they will use these strategies to prevent or completely develop type 2 diabetes from progressing.
Complications
A number of complications can lead to both type 1 and type 2 diabetes, including:
- eye damage
- foot problems
- heart and blood vessel disease
- kidney disease
- diabetic ketoacidosis, in which the body breaks fat down as a source of fuel
- nerve damage
However, frequently monitoring blood sugar levels and using insulin to keep them within a particular target range helps reduce the risk and delay the development of complications of diabetes.
Insulin sensitivity factor and type 2 diabetes
Assessments of the insulin sensitivity factor are only useful for individuals with type 1 diabetes who no longer produce insulin.
Some quantities of insulin in their pancreas may still be produced by people with type 2 diabetes, so they can not accurately measure their insulin sensitivity factor.
To figure out what is best for them, people should make sure to speak to their doctor.
In order to lower their blood sugar levels, people with type 2 diabetes should concentrate first on nutrition and lifestyle changes.
After this, medication, such as metformin, may be recommended by a doctor. This works by reducing the amount of glucose released into the bloodstream by the body and making the cells of the body more insulin sensitive.
Outlook
Diabetes can be a severe disorder, but with the right medication and guidance, a person with this condition can live a normal life and delay the onset of complications.
Following the treatment plan and using insulin and other drugs, as instructed by the doctor, is important. After first speaking to their healthcare provider, people should not change their regime.
