In a non-diabetic person insulin is released from the pancreas to help control your blood glucose level which normally starts to rise after you eat anything with sugar in. So what you are doing when injecting insulin several times a day is to imitate the normal pattern of insulin production from the pancreas as closely as possible (for more information see Diabetes UK's website).

Types of insulin

There are several types of insulin available but their basic difference is in how quickly they take effect. So insulin can be divided into three main types: short, medium or long acting. It is possible to mix short and medium acting insulins in the same syringe but there are also ready-mixed preparations, which contain quick and medium acting insulins in different proportions. All three types of insulin may be made from animal sources - pig or beef - or, alternatively, from genetically engineered human hormone. Analogues insulin is synthetic insulin produced by genetic engineering and are the latest types of insulin. Analogues insulins are efficiently absorbed by the body either more quickly or more slowly. Quick acting analogues (Humalog or NovoRapid) can be injected before, during or after a meal and are particularly good for people with variable meal times. There are two long acting analogues available in the UK (Lantus and Levemir). These insulins are given once daily and preferably at the same time each day.

Here young people talk about the types of insulin they have used, the one they are currently using and in some cases why they have change their insulin regimen. 

While some young people preferred not to change their current insulin regimen because they worry it might mean increasing the number of injections per day, others described how, since changing their regime, they no longer need to eat snacks between meals which meant that their lives had become much easier. 

She does not like the idea of injecting more than two times per day.

Reasons for changing your insulin

Most of the young people we talked to had changed their insulin regimen one or more times since they had first been diagnosed. Many young people said that they had found it, or were now finding it, difficult to control their diabetes during their teen years and that this was the main reason why they had changed their insulin regimen. They talked of their control worsening as they reached puberty due to hormonal changes and of experiencing more frequent and unexplained hypos and/or highs. But the teen years were also recognised as a time when young people wanted to be able to be much more independent and flexible about what and when they did things and so needed to find insulin regimes which allowed them this independence. (See also 'Hypos', 'Highs'; 'Diet and diabetes' and 'Managing diabetes as a teenager'.)  

Recently he changed to another insulin regimen because he started to have problems controlling his diabetes when he reached puberty.

His consultant suggested that he tried another insulin regimen because he was having lots of hypos in the morning.

He likes his new insulin regimen but strongly dislikes the disposable pen that he needs to use with the Lantus insulin.

Some young people said that their previous insulin regimen had been inflexible and too complicated. Some who remembered using syringes and having to draw up and mix the insulin in the past preferred being able to use pens because they are more practical and less of a hassle. Another issue raised by many young people was that they didn't like regimes where they had to eat snacks between meals whether they felt hungry or not. 

She found that as she grew up her insulin regimen was too inflexible and unpractical.

Some young people reported having experienced problems with some types of insulin regimen. One young woman diagnosed as a child became irritable and very lethargic when starting to use a new insulin regimen. In her case doctors kept trying various types of regimen until they found one that suited her and her lifestyle. A young woman who had been on the same insulin regimen for thirteen years was advised to change to another type of insulin which would allow for a more flexible regime. One week later she became very ill and was admitted into hospital with DKA (diabetes ketoacidosis). She had several episodes of DKA which didn't stop till after she was put back onto her original type of insulin but with more frequent injections. It is very important to recognise that you need to closely monitor your blood glucose levels - doing the 'finger pricking' - as instructed by your consultant or nurse, especially when you are changing your insulin regimen. 

Her insulin was changed to give her greater flexibility but she reacted badly to the new insulin and ended up on the original insulin but with more frequent doses.

Flexible insulin regimen

Many of the young people we talked to said that analogue-type insulin gives them much more flexibility and independence and a better control. They pointed out that they do not have to wait before having a meal; that they can inject and eat straightaway. However they did also say that knowing more about carbohydrate counting helped (see also 'Diet and diabetes'). One young man pointed out that at the start of his new regimen he felt a bit upset because he couldn't see any noticeable improvements. A young woman indicated that initially she found that too much freedom can be a problem because she started to eat more chocolate than usual. Young people really appreciated the fact that their new regime meant that they were now able to have 'a lie' in rather than having to wake up early at weekends just to do their insulin injection.

Talks about how she had to learn to do carbohydrate counting when started using fast acting insulin.

Says that one of the advantages of her insulin regimen is that she can have a lie in.

Fixed insulin regimen

Some young people prefer a more fixed routine because they find that it helps them to manage their diabetes better. A young man indicated that it is a good idea to be on a set routine when you are first diagnosed because otherwise the prospect of going it alone would be too scary. A young woman who used to have a insulin pump changed back to a fixed insulin regimen and does not see the need to change to a four injections a day regimen.

He found his fixed insulin regimen a pain but prefers it to the flexible one.

It was reassuring to have a fixed regimen when first diagnosed.

Initially she found it difficult to go back to injecting insulin after using a insulin pump. She says that her diabetes is well controlled under her present insulin regimen.

Finding the right insulin regimen depends on being aware of what your eating patterns are likely to be and checking the results with daily glucose tests especially when you unexpectedly eat more or less than usual. (See also 'Diet and diabetes', 'Doing blood glucose tests' and 'Managing diabetes as a teenager'.)

Last reviewed April 2010.

Last updated April 2010.