Insulin therapy should be considered when blood glucose levels are consistently very high or when other treatments are not achieving desired results.
Understanding the Need for Insulin
Insulin is a hormone that helps your body use sugar (glucose) for energy. When your body doesn't produce enough insulin or doesn't use it properly, it can lead to high blood sugar levels. This condition, known as diabetes, often requires insulin treatment.
Key Indicators for Starting Insulin
According to guidelines, the initiation of insulin replacement therapy should be considered in the following situations:
- High Blood Glucose Levels: When your blood glucose levels consistently reach 300 to 350 mg per dL (16.7 to 19.4 mmol per L) or more.
- Elevated A1C: When the A1C level is more than 10% to 12%. A1C reflects your average blood sugar over the past 2-3 months.
- Augmentation Therapy Failure: For individuals already using basal insulin along with other medications (augmentation therapy), the addition of rapid-acting insulin should be considered if A1C goals are not being met.
Practical Insights:
- Immediate Intervention: High glucose levels (above 300mg/dL) can be dangerous. Starting insulin promptly can help stabilize these levels and prevent further complications.
- A1C Goal: Keeping your A1C within the target range, usually below 7% for most people, is vital to manage diabetes and prevent long-term health issues.
Types of Insulin to Consider:
- Basal Insulin: Provides a background level of insulin.
- Rapid-Acting Insulin: Used to manage blood sugar spikes, typically taken before meals.
Treatment Scenarios:
Here is a summary of when to consider insulin treatment, based on different circumstances:
| Situation | Insulin Consideration |
|---|---|
| Blood Glucose consistently above 300-350 mg/dL | Initiate insulin replacement therapy |
| A1C consistently above 10-12% | Initiate insulin replacement therapy |
| On Basal insulin and augmentation therapy, not at A1C goal | Consider adding rapid-acting insulin |
Summary
The decision to start insulin therapy is usually based on a combination of blood sugar levels and A1C results and whether existing medication is meeting the target. If you are experiencing high blood sugar levels, consult with your doctor about whether insulin therapy is necessary.
