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Insulin

Insulin is a naturally occurring hormone that’s used to treat Type 1 diabetes, and occasionally Type 2 diabetes. It’s injected into the body to help stabilise glucose (blood sugar) levels. 

  1. Treats diabetes.
  2. Is a synthesised version of the naturally occurring hormone.
  3. Available in two forms.

If you have any concerns related to either Type 1 or Type 2 diabetes, you can speak with one of our GMC-registered clinicians via our online video consultation service. It’s available from 9.30am-4.30pm, Monday to Friday.

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Product information

What is insulin?

Insulin is prescribed to people who have Type 1 diabetes, and in some cases Type 2 diabetes. Insulin is produced naturally in the body to convert sugar into energy. People with Type 1 diabetes are not able to produce this hormone naturally, resulting in dangerous spikes in blood sugar levels. 

In cases of Type 2 diabetes, the body may still produce some insulin, but not enough to keep blood sugar levels stable. You’re more likely to develop the condition if you have high amounts of sugar in your diet or are overweight. 

What symptoms does diabetes cause?

Symptoms relating to Type 1 diabetes can develop quickly, especially amongst children. The most common indicators of Type 1 diabetes include extreme thirst, frequent urination, altered vision, minor wounds that do not heal, recurring thrush infections, weight loss and fatigue. If you experience these symptoms you should seek immediate medical attention, as the condition can be life threatening. 

Symptoms of Type 2 diabetes are very similar to Type 1, but may not make you feel unwell and therefore some people may not be aware that they have the condition. If you suspect that you may have either Type 1 or Type 2 diabetes, you should make an appointment to see your doctor immediately for a diagnosis. 

How is diabetes diagnosed?

Your clinician will likely conduct a urine and blood sugar test. If they suspect that you have Type 1 diabetes, you will usually be referred to hospital, where you will be monitored until your blood test results have been processed. Having been diagnosed, a nurse will be able to advise you about how to manage the condition, including injections of insulin. 

Insulin is available in two forms: it’s either administered once or twice a day, or injected before meals (or any snacks or drinks with carbohydrate in them). Insulin that is taken either once or twice a day is called basal (or background) insulin, and keeps your insulin levels stable throughout the night and in between meals. Bolus insulin is taken with meals, drinks or snacks containing carbohydrate, and helps to keep your blood sugar levels within a healthy range by preventing spikes from occurring. 

In cases of Type 1 diabetes, you may experience what is known as a honeymoon period having only recently developed the condition. This is where your body still produces some insulin, and the condition may be easier to manage as such. Over time, however, this usually changes, and you will typically find that you need to adjust your daily insulin dosages. Your prescribing doctor, or your diabetic nurse, can advise you on this.

Symptoms of Type 1 and Type 2 diabetes are very similar, but the strains of the condition differ in terms of cause. Type 1 diabetes is thought to be an autoimmune condition, in which healthy beta cells are destroyed by the body itself in the pancreas, resulting in the body not being able to produce any insulin. The development of Type 2 diabetes is usually linked to being overweight and inactive, or a family history of the condition. 

Who gets diabetes?

It’s not clear why people develop Type 1 diabetes, or what the risk factors for the condition are, but it’s understood that you are at greater risk of developing Type 2 diabetes if you have a relative with the condition, are over the age of 40 or are from a southern Asian, Chinese, sub-Saharan African or Caribbean ethnic background. 

Most cases of Type 2 diabetes are discovered during blood tests for other conditions, but it is essential that you are tested for it if you experience any diabetic symptoms. You can get tested for Type 2 diabetes at your local GP surgery, and test results are usually available within one to two days. If you get tested for Type 1 diabetes however, and your doctor suspects that you have the condition, you will normally be referred to hospital to await your blood test results, so that your blood sugar levels can be closely monitored. 

Once you have been diagnosed, your doctor will be able to inform you about the condition fully, as well as the risks involved. Both Type 1 and Type 2 diabetes can have serious health consequences if they’re not well managed. 

How is diabetes treated?

Besides the use of insulin to control blood glucose levels, there are a number of ways in which diabetes can be treated. Making changes to your lifestyle, such as taking regular exercise, can help you to regulate your blood sugars, and to lose weight if you are overweight. Making adjustments to your diet may also help, including lowering your sugar and salt intake, and eating at least five portions of fruit and vegetables every day. 

It’s important that you do not skip meals and eat at regular intervals, preferably without snacking. These changes can be made gradually, with small modifications made over a few months, as coming to terms with a diagnosis can be daunting to begin with for some people. 

Medication for Type 2 diabetes may not be required immediately after diagnosis, but as the condition tends to worsen over time, it is likely that it will be needed over the longer term. Metformin is the most commonly prescribed treatment for Type 2 diabetes, and helps to lower blood sugar levels. However, if it is not effective within three months, your prescribing clinician may explore alternative medications with you. 

Insulin is a rarely used treatment amongst people who are in the early years of a Type 2 diabetes diagnosis, and is only required when other treatments are no longer working properly. 

If you would like to discuss Type 1 or Type 2 diabetes with a registered clinician, our online video consultation service is available from 9.30am-4.30pm, five days a week.  Our clinicians can also issue fit notes and referral to specialists for treatment, where appropriate. 

Page last reviewed:  17/07/2020
Side effects and warnings

What side effects can insulin cause? 

Side effects are possible with any medication, and you should make sure that you know what these are before taking any specific treatment. Your prescribing doctor or nurse will be able to discuss any potential side effects with you, and you can also refer to the patient information leaflet that comes with your medication. 

The following side effects relate to the basal insulin Lantus, and may not apply to your specific medication. 

If you notice any of the following symptoms, you should seek immediate help as it may be an indication of low blood sugar levels (hypoglycaemia), which can be life threatening: loss of consciousness, dizziness, sweating, shaking, hunger, headaches, anxiety, irritability, clumsiness, weakness of the muscles, altered vision or speech, and seizures. 

The following symptoms may be a sign of a severe allergic reaction, which also require immediate medical attention: rashes, swelling of skin or mucous membranes, shortness of breath, a fall in blood pressure, rapid heartbeat and sweating.

Other symptoms include: 

Common reported side effects (may affect up to 1 in 10 people): skin changes at the injection site, fatty tissue under the skin. Please note that this can lead to the insulin becoming less effective, so it is important to change the site of injection regularly. 

Rare reported side effects (may affect up to 1 in 1,000 people): eye reactions, changes in your blood sugar control and a build-up of water in the body.

Very rare reported side-effects (may affect up to 1 in 10,000 people): Dysgeusia and myalgia.

Can insulin cause interactions with other medications? 

The use of other medications alongside insulin can result in either an increase or decrease in your blood sugar levels. It’s therefore essential to tell your doctor about any medications you are currently taking to ensure that insulin is safe for you to use. This is particularly important if you are taking any of the following: ACE inhibitors , disopyramide, fluoxetine, fibrates, monoamine oxidase (MAO) inhibitors, pentoxifylline, propoxyphene, salicylates, sulfonamide antibiotics, corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, oestrogens, progestogens, phenothiazine derivatives, somatropin, sympathomimetic medicines, salbutamol, thyroid hormones, atypical antipsychotic medicines, protease inhibitors, beta-blockers, clonidine, lithium salts and pentamidine.

Warnings and precautions when using insulin 

There are no health conditions that render the use of insulin unsuitable, but it’s imperative that your prescribing clinician is made aware of any health conditions or problems you are currently experiencing, or are prone to, so that the most suitable treatment can be prescribed for you.  

What types of insulin are available? 

Insulin is available in two forms: basal and bolus. Basal insulin is taken once or twice daily at the same time, whereas bolus insulin is taken before meals, snacks or drinks that contain carbohydrates. The type of insulin you require, as well as the dosage, depends on your specific needs, and whether your body is still producing any insulin at all or not. Your prescribing clinician and diabetic nurse will be able to help you to establish what dosage and insulin is best for you following diagnosis. The type of treatment you require and the dosage will likely change over time.

Can you take insulin if you are pregnant?

It’s essential that you tell your doctor if you are pregnant, suspect you might be pregnant, are planning on becoming pregnant or are breastfeeding, either before starting treatment with insulin or if you are currently taking it. The levels of insulin may need to be adjusted to help manage diabetes and to protect the health of your baby.

Page last reviewed:  17/07/2020
Questions and Answers

Can insulin affect my ability to drive? 

Insulin itself should not affect your ability to operate any heavy machinery, but diabetes can. Your blood sugar levels need to be carefully monitored to prevent hypoglycaemia (low blood sugar) or hyperglycaemia (high blood sugar), which can be life-threatening. In rare cases, your vision may be altered through using insulin, and so you should ensure that you know how this treatment affects you and whether you have taken the correct dosage of insulin before driving.

Is it safe to drink alcohol whilst taking insulin?

Yes, but you should only consume alcohol in moderation and stick to national guidelines. It’s very important to be aware of the risks of hypoglycaemia when consuming alcohol. Your prescribing doctor or diabetic nurse can advise you on these risks.    

Can I buy insulin over the counter? 

Insulin requires a prescription, but in the event of an emergency, it may be available over the counter from your local pharmacy. In these circumstances, the following factors are usually considered: whether you have been previously prescribed it, that you will take it immediately and whether there is evidence of a safe dosage for you.

Can I buy insulin online?

You can speak to a GMC-registered clinician about insulin using our online video consultation service. Our clinicians are available for appointments between 9.30am-4.30pm, Monday to Friday. They can also provide referrals to specialists for treatment and fit notes, where suitable. 

Please note that if we are able to issue treatment for any of the above conditions, our prescriber or pharmacist will need to access your summary care record to make sure that you’re already taking it. We can only provide a prescription for diabetic medication if you are already using this treatment. 

Page last reviewed:  17/07/2020

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