How does a doctor figure out how much insulin a type 2 diabetic should take?

Answer 1

Many people with type 2 diabetes only have to take a med (like Glucophage) and not use insulin. It is important that you monitor the blood sugar and consult your doctor. Ussually if on insulin it is a small dose daily of long acting insulin. Many times with diet and exercise type two diabetics can control this and possible return to just testing daily.

Answer 2

Regardless of which type of diabetes you have most doctors will base your starting dose based on how much you weigh and see how it works over a few days and start upping it from there. Everyone is different. Some people will have more insulin resistance than others and it will take a lot more insulin to get control. Most of the time type 2's are started on a longer acting insulin requiring only one or two injections per day and the dose is upped until the person is getting control. It's not uncommon for a type 2 to be taking a couple hundred units per day, which is shocking to many type 1's as that much insulin would kill them. I don't mean to offend anyone, but a sliding scale is a date treatment option. It's called chasing the blood sugar because you're correcting all the time instead of taking insulin based on what your body needs and what you're eating. Some type 2's can manage with just long acting in the beginning because they're still making their own insulin and with the added insulin they're bodies are able to function more like it's supposed to. But that may not be the case for everyone. It's important to take it slowly. That's hard to do when your glucose is too high, but you do not want more insulin injected that you need. Once it's there you can't take it back. Many people make the mistake of thinking that once you start insulin you should normal blood over night. But if you take enough insulin today to bring down a blood sugar to normal when it was elevated and then you take the same amount tomorrow when you have a normal blood sugar you will overdose and may find yourself unconscious or worse! It takes a few days for your glucose to settle after each addition of units, there is a method to the madness.

Answer 3

Figuring out how much insulin someone needs is not an exact science, and for a type 2 diabetic, the insulin requirements vary depending on how poorly controlled the glucose is to begin with.

One way to figure it out is to start off with an "insulin sliding scale". This is done by having the patient check his/her glucose before each meal and before bedtime, and depending on how high the sugars are, giving a predetermined amount of short acting (regular) insulin. Adding up the amount of insulin requirements over a 24 hour period then let you approximate how much the insulin need is which can then subsequently be given by long-acting insulin (NPH or Lantus) or a combination of long and short acting insulin, with or without continuing on oral diabetic medications.

Answer 4

I particularly like the dartboard answer ^_^.

The truth is that although not all type 2 diabetics require insulin, for those that do, there is no science for telling just how much, we do it by trial and error. We look at fingerstick glucose measurements at 4 different time points a day for as many days as we have the information and try to determine just when we need to get sugar down and how much it needs to go, select the proper type of insulin (and there are several from which to choose, with different profiles of action) then we guess, see what happens, and tweak afterwards.
Basically, it's up to the patient, the patients who come in to us having taken all of their medications as directed and with lots of information, many fingerstick measurements at the right times of the day generally get better care because we really have the information to see exactly what we're doing and where we might need to make a change. For those who give us less information and maybe don't take their insulin as they're supposed to we do the best we can, but it's a much harder situation to get good control in.

Answer 5

Most type 2 diabetics start out controlling their diabetes with diet and exercise. Then it goes to pills. If it is still not being controlled, a doctor will prescribe insulin. To be honest, it's really a guessing game with the doctors. They usually start you out on a low dose though because it's better to give not enough than too much. Then they adjust it based on how well or how poorly your diabetes is being controlled.

Answer 6

Mine did it by trial and error. Started with low dose, worked up till it was controlling the blood sugar as needed. Usually done in a hospital setting, unless he/she considers the patient to be competent to make that decision at home.

Answer 7

trial and error

Answer 8

good question, I think they have a dartboard.