Diabetes Self-Management Articles

These articles cover a wide range of subjects, from the most basic aspects of diabetes care to the nitty-gritty specifics.

Links not loading properly?

Some of our pages use Portable Document Format (PDF) files, which require Adobe Acrobat Reader. To download Acrobat Reader for free, visit www.adobe.com.

Sign up for our weekly e-mail newsletter and receive a FREE GIFT! Enter your e-mail below.

Learn more

Learn more about diabetes

Links to help you learn more about diabetes.

Ask a diabetes expert
Other diabetes resources
Browse article topics


Understanding Insulin

by Laura Hieronymus, MSEd, APRN, BC-ADM, CDE, and Patti Geil, MS, RD, CDE

Types of diabetes
In Type 1 diabetes, an autoimmune process destroys the insulin-producing beta cells of the pancreas, leaving it unable to make insulin. People with Type 1 diabetes must therefore inject or infuse insulin for survival. While some people appear to have a genetic predisposition to develop Type 1 diabetes, exactly what sets off the autoimmune destruction of the beta cells is unknown.

In Type 2 diabetes, some degree of insulin resistance is typically present. Initially, the pancreas may release more insulin than normal to compensate for the insulin resistance, but eventually, the pancreas is believed to “burn out” from overproduction, and blood glucose levels rise. However, treatments other than insulin therapy are usually tried first for Type 2 diabetes. In most cases, insulin resistance can be improved with moderate weight loss, so treatment recommendations generally include lifestyle adjustments such as changes in diet and increased physical activity. Oral blood-glucose-lowering medicines are also often used in the treatment of Type 2 diabetes. (These oral medicines are not insulin.) If dietary changes, increased physical activity, and oral medicines are unable to keep blood glucose levels adequately controlled, insulin therapy may be added to the diabetes treatment regimen or substituted for the oral drugs.

Diabetes and pregnancy
In any pregnancy, the need for insulin dramatically increases around the 16th week of gestation. From then on, more and more insulin is necessary to maintain normal blood glucose levels as the pregnancy progresses.

In women with Type 1 diabetes who are pregnant, careful blood glucose monitoring to adjust insulin doses is necessary over the course of the pregnancy. In women with Type 2 diabetes, insulin is usually the drug of choice to manage blood glucose levels during pregnancy and also requires adjustments, as needed, throughout the pregnancy. Women with Type 2 diabetes who are taking oral blood-glucose-lowering medicines prior to pregnancy are urged to plan their pregnancy and, typically, to begin using insulin prior to conception. While a few studies have examined the use of oral diabetes drugs during pregnancy, many health-care providers feel they do not yet know enough about the effect of these medicines on the fetus to advocate their use at this time.

A temporary type of diabetes that complicates about 7% of all pregnancies among women not diagnosed with either Type 1 or Type 2 diabetes is called gestational diabetes. The high blood glucose levels that occur in gestational diabetes are usually first recognized around the 24th to 28th week of pregnancy. They are due to increased insulin resistance, which is generally caused by the pregnancy hormones as well as the weight gain that normally occurs in pregnancy. About 75% of women with gestational diabetes can maintain normal blood glucose levels by making lifestyle changes, such as following a meal plan and getting regular physical activity. However, if blood glucose levels remain too high, insulin is currently the drug of choice for treatment for gestational diabetes.

Synthetic insulin
Insulin that is used in diabetes treatment is not and never was extracted from human pancreases (although earlier forms of insulin were, in fact, extracted from pig and cow pancreases). Human insulin is manufactured using recombinant DNA technology (often called genetic engineering) in a laboratory; it is identical in structure to what a human pancreas produces. Insulin analogs, which are structurally different from human insulin, are also manufactured in labs using similar processes.

Page    1    2    3    4    5    6    Show All    

Also in this article:
Treating Hypoglycemia
Types of Insulin
Insulin Injection Sites



More articles on Insulin & Other Injected Drugs
More articles on Diabetes Basics



Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



My Battle With the Glycemic Index
Being diagnosed with Type 2 diabetes meant I had to come to terms with what had to change in... Blog

Fear and Diabetes…
So I missed Halloween with this post, which is a shame because it's such a great tie-in. Nevertheless,... Blog

Discovering I Had Type 2 Diabetes
An image from three decades ago has stuck with me, though I've tried to forget it. I was watching... Blog

What should I keep in mind if I'm switching from syringes to insulin pens? Get tip