Life with type 2 diabetes may mean using insulin to help control your blood sugar levels. There are several different types of insulin that you and your healthcare provider can use to keep your diabetes in check.

If your doctor talks about long-acting insulin and you aren’t sure what that means, don’t worry. Here’s what you should know about this important medication for controlling diabetes.

1. Long-Acting Insulin Is a Type of Basal Insulin

When people think about injecting insulin, they usually envision something that they take every time they eat. However, there are other kinds of insulin, too. Long-acting insulin is a form of what doctors call basal insulin. This is insulin you only have to inject once or twice a day. It can be used alongside shorter-acting forms of insulin. It may be used on its own, too. All of that depends on your body and how your particular blood sugar responds to insulin.

What’s the Name of the Longest-Acting Insulin?

The longest-acting insulin currently available is degludec (Tresiba). It can last up to 42 hours. It’s important to note that it may not last that long for you. Keep in mind that reaching steady-state (the blood concentration plateau) takes three to four days, so the dose should only be increased after four days. How long insulin works in your body can vary based on a number of factors, like how much insulin you make on your own and how much you eat.

2. Long-Acting Insulin Is Different From Short, Rapid, and Intermediate-Acting Insulin

Long-acting insulin is different from short-acting insulin, rapid-acting insulin, and intermediate-acting insulin. Short-acting insulin is also known as regular insulin, so long-acting insulin is different from that, too.

All of these types of insulin start working faster and don’t last as long as long-acting insulin. This can make them useful for times when you need to regulate your blood sugar fast.

In general, long-acting insulin will take several hours to start working and can last up to 24 hours. Sometimes, as noted above, it can last longer than that. It’s usually used to keep your blood sugar balanced all day, including overnight when you may not be able to take other forms of insulin without disrupting your sleep.

3. Ultra-Long-Acting Insulin Is a Type of Long-Acting Insulin

Some insulins are now known as ultra-long acting insulins. These medications can take up to six hours to act, but can last for 36 hours or more. The longest acting one, degludec, is technically one of these. While some people list degludec as long-acting, others describe it as the only member of the ultra-long-acting category approved in the U.S.

Most of the time, this won’t matter. You can use your insulin as instructed regardless of what category it falls into. However, your doctor may use these terms, so it’s important to know what they're talking about.

4. Long-Acting Insulin Is One Way To Lower Blood Glucose Levels

When you’re living with type 2 diabetes, your body usually makes insulin but doesn’t use it the way it should. It becomes resistant to insulin, so you need to make more and more to have the same effects. If it can’t keep up, your blood sugar levels go up and you develop type 2 diabetes. Sometimes, type 2 diabetes may mean that your pancreas doesn’t make insulin, or doesn’t make enough for your needs.

Whether your body isn’t making enough insulin or isn’t using it well, injecting insulin can help your body get what it needs. Long-acting insulin is one way to make sure your body always has the insulin it needs. It will release a little at a time, supporting your body all day long.

5. When You Take Long-Acting Insulin Depends on Several Factors

There’s no single schedule for injecting long-acting insulin. Instead, your doctor will help you develop a schedule for insulin injections that accommodates your lifestyle, your job, your sleeping hours, and more.

In addition, different long-acting insulins work differently from each other, too. Your schedule will also depend on which type your doctor prescribes for you. The options are:

• Detemir — It takes a few hours for it to kick in, and it can last between 20 and 24 hours. You’ll use it once or twice a day.
• Glargine — It has about the same stats as detemir, but you’ll likely only inject it once a day.
• Degludec — As mentioned above, it can last for more than 24 hours. Most people use it once a day.

Your healthcare team may tell you to use long-acting insulin in other ways and situations, too. You should always follow their advice as closely as possible so you can get maximum control over your blood sugar. Long-acting insulin may help you achieve these goals all the time, not just after meals.

6. Long-Acting Insulin Has a Few Risks

Long-acting insulin is, by and large, safe. However, there are a few risks that you may develop. They include:

• Problems at the injection site, such as itching, skin discoloration, pain, or bruising
• Fatty lumps that develop under your skin
• Problems with your vision
• Hypoglycemia (low blood sugar), which the longest-acting insulin, degludec, has a lower risk for

Low blood sugar can be a major problem. It’s more likely to happen in certain situations, like when:

• You drink more alcohol than usual, especially liquor.
• You exercise intensely.
• You miss meals or eat later than usual.

You may feel dizzy, shaky, sweaty, or anxious when you’re experiencing hypoglycemia. Over time, you’ll figure out what your symptoms are. Your doctor will tell you what to do if you end up with low blood sugar. Usually, the first step is to eat or drink some glucose that’s easy to digest. This will help raise your blood sugar.

7. The Benefits of Long-Acting Insulin Outweigh the Risks for Most People

If type 2 diabetes isn’t managed, it can affect a lot of things in your body. This includes your mouth, ears, sexual function, heart, lungs, eyes, digestive tract, nerves, skin, and kidneys. It’s very important, then, to keep your blood glucose levels under control as much as possible. That way, you may not have to deal with these complications. Since long-acting insulin can help control blood glucose levels, it’s often worth the possible risks involved in using it.

8. Your Doctor Will Tell You All About Using Long-Acting Insulin

You’ll work closely with a healthcare team to figure out how much long-acting insulin to take, when to take it, and whether you need other insulins or medications to help control your blood sugar. If you have questions, talk to your healthcare team right away because they can get you the answers you need.

Your doctors may ask you to track how well your body responds to insulin. This may be more true at the beginning of your treatment for type 2 diabetes. For instance, you may need more insulin or more frequent injections than what is initially prescribed. You may also need to take insulin at certain times of day.

If tracking insulin and blood sugar levels is hard for you, talk to your doctor about using a patch or an insulin pump. These can help you assess your glucose levels and make sure you get the treatment you need when you need it. Your doctor can also monitor your A1c levels over time to make sure your type 2 diabetes is under control over the long term, as well as the short term.

Your doctor should be an ally for you as you learn to live with type 2 diabetes. Anytime you have a question about long-acting insulin, talk to them to get the answers you need.

Talk With Others Who Understand

DiabetesTeam is the social network for people with diabetes and their loved ones. On DiabetesTeam, members come together to ask questions, give advice, and share their stories with others who understand life with diabetes.

Do you use long-acting insulin to help control type 2 diabetes? How has it helped you to feel better and live better? Share your experience in the comments below, or start a conversation by posting on your Activities page.