You have now finished Section 2 of the Diabetes / Insulin Tutorial - and are shifting from learning what kind of insulins are available to understanding how it might be possible to use them to improve the regimen of someone with diabetes.
We have learnt that of the two forms of insulin therapy:
conventional insulin therapy requires less injections - one or two injections a day - but offers less flexibility. On this regimen, people with diabetes would have to adjust their lifestyle to fit insulin availability.
intensive conventional insulin therapy requires four injections a day, but gives people with diabetes much more power to adjust insulin delivery to fit their lifestyle, and still achieve good diabetes control.
We have seen that as diabetes progresses it will be necessary to move to intensive conventional insulin therapy, based on blood glucose determinations, to continue to achieve good metabolic control.
Section 2 of this Tutorial has moved on to quantitative issues and has offered hints on how much the insulin dose may be adjusted when a change is required.
Insulin doses are generally increased or decreased according to the measured
blood glucose readings. The general 'rule' is that regular insulin can be changed twice as much as long-acting insulin. The actual rate of change must be adjusted to each patient's individual requirements. Also, the dose of long-acting insulin should be changed much less frequently, while the regular insulin often needs much more frequent changes.
If you have diabetes, you will need to work out a chart, with your doctor's help, providing rules about when and how much you maybe should consider changing your insulin dose.
We have discussed six real patient examples, to show how these 'rules' might be applied to everyday life.
In the next lesson (Section 3) we will learn how it may be possible to make use of the greater flexibility of intensive conventional therapy to vary one's diet according to personal preferences and to manage special situations.
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