Starting insulin can feel like a big adjustment, and it’s normal to have some worries at first. Insulin works to lower your blood sugar, which is why timing your dose carefully is important. Taking it too early or too late can cause your blood sugar to go too high or too low. With the right plan and a little practice, though, you’ll learn how to make insulin fit into your routine.

Your healthcare provider will help you create an insulin plan that fits your needs. In the meantime, here’s a general overview of what a type 2 diabetes care plan with insulin might look like.

How Does Insulin Work?

After you consume food or drinks with calories, your blood sugar levels increase. Blood sugar levels rise because your digestive system breaks down what you ate or drank. It releases energy from food in the form of sugar.

Insulin helps the body use sugar in the blood. Blood sugar is either used immediately for energy or stored for later use as glycogen or body fat. However, people with type 2 diabetes either don’t make enough insulin or the insulin they do make doesn’t work well. Injecting insulin medication helps fill these gaps and keep your blood sugar levels in a safe target range.

Different Types of Insulin

Insulin comes in different forms. Some act fast. Others take longer to kick in, but the effects last for longer. Understanding the action of your insulin medication is essential to get the timing right.

Rapid-Acting Insulin

Rapid-acting insulin is the fastest type. It starts working within 15 minutes of being injected. The biggest impact happens within one to two hours, and it completely wears off after four hours.

Short-Acting Insulin

Regular or short-acting insulin takes half an hour to start working. Its effects peak at the two- to three-hour mark and might last for a maximum of six hours.

Intermediate-Acting Insulin

Next is intermediate-acting insulin. It enters the bloodstream within two to four hours after injection and peaks between four and 12 hours later.

Long-Acting and Ultra-Long-Acting Insulin

There’s also long-acting insulin, which takes several hours to reach the bloodstream. However, its glucose-lowering effects last for a full 24 hours. Finally, ultra-long-acting insulin doesn’t peak. Instead, this type works steadily for 36 hours or more. However, it can take six hours for ultra-long-acting insulin to reach the bloodstream after you inject it.

Some people with type 2 diabetes pair long-acting insulin with an insulin inhaler. Inhaled insulin works the fastest, within just 12 to 15 minutes. It peaks in 30 minutes and stops working after two hours.

Premixed Insulin

Drug manufacturers also make premixed insulin. It’s a combination of rapid and longer-acting insulin, so it offers the best of both worlds. Premixed insulin usually starts working within 10 to 20 minutes and can last up to 16 hours. Your healthcare provider may suggest premixed insulin to help simplify your insulin routine.

Timing of Rapid vs. Long-Acting Insulin

Rapid- and short-acting insulin should be taken around the same time as your meal. It’s also known as bolus insulin. You may inject it just before you eat or immediately after you finish eating. Since these faster forms of mealtime insulin begin working quickly, they help keep blood sugar levels from spiking after you eat.

You may need to adjust how many units of insulin you inject based on your starting blood sugar and how many grams of carbohydrates are in your meal. A registered dietitian who is a diabetes educator can help you sort out the specific details of your plan.

In addition, blood sugar doesn’t just go up in response to eating. If you haven’t eaten in a while, your liver releases stored sugar into your blood to help supply your body with energy. This is why people with type 2 diabetes often have high blood sugar levels first thing in the morning. Long-acting insulin helps control high blood sugar throughout the day and night, even when you’re not eating. You may also hear long-acting insulin referred to as your background or basal insulin.

One member of DiabetesTeam described how they take both forms of insulin: “I take short-acting insulin three times a day and one long-acting before going to bed. I test before meals and in the middle of the night to make sure that my sugar levels don’t drop too low.”

Fitting Insulin Into Your Daily Life

Getting the timing of your insulin right is important, but it’s not always easy. It’s simpler when your days follow a regular pattern — but for most people, life isn’t that predictable. Changes in meals, activity, stress, or illness can all affect your blood sugar and how much insulin you need.

Other variables affect blood sugar levels and insulin needs. For example, if you get sick, skip a meal, go out for a big dinner, or do an unusual amount of physical activity, your insulin needs may be different that day. Fortunately, you can check your blood glucose levels and adjust your insulin dose when things don’t go as expected. You should also develop an emergency plan with your healthcare team that outlines what to do if your blood sugar spikes or drops.

A continuous glucose monitor makes it easier to keep track of your blood sugar levels. It’s a sensor that’s placed under the skin to give you real-time updates on blood sugar changes. A continuous glucose monitor shows real-time changes in your blood sugar levels, helping you know when it’s time to take insulin or make other adjustments.

In addition, insulin pumps can simplify your insulin injections. This small wearable device can balance blood sugar and insulin delivery throughout the day and night. An insulin pump can coordinate dose delivery with continuous glucose monitor readings. Using new diabetes technology can help you better control your blood sugar, lower your risk of complications, and make daily life easier.

What Members Say

Members of DiabetesTeam have shared their success with insulin pumps. “This pump helped me big time with my sugars,” said one member. “My starting A1c was 7.1, and now it’s 6. I’ve also lost 30 pounds. My in-range numbers are usually 80 to 100 percent.”

Another wrote, “I have been through all the various forms of medication and am now using an insulin pump, which helps to reduce the number of times I have to poke my body. I used to be doing five or six shots a day, but now I just change the insertion set once every three days. In the meantime, just set the pump to deliver the insulin for my meals and background insulin. It works well for me.”

Talk to Your Doctor

Starting insulin comes with a learning curve, and it’s OK to have questions along the way. If you’re unsure about your plan, talk with your healthcare provider. They may recommend diabetes classes where you can learn more about insulin and everyday ways to manage your condition. There are many helpful resources available — don’t hesitate to use them. Getting support can make it easier to take control of your health.

Find Your Team

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

Do you inject insulin to improve your blood sugar or glycemic control with type 2 diabetes? Have you considered getting an insulin pump to simplify your routine? Share your comments below, or start a conversation by posting on your Activities page.