If You Have Type 1 Diabetes, You Should Know That:

• Your body makes little to no insulin
• You need insulin injections every day to replace the missing insulin

If You Have Type 2 Diabetes:

• Your body either does not make enough insulin or cannot effectively use the insulin it does make
• Diabetes pills can help your body make a little more insulin and use the insulin the body makes more effectively
• If diabetes pills are not able to keep your blood glucose in control you will have to take insulin injections to control your blood glucose

How and When Different Insulin Works
Insulin works to move the sugars from the food you eat out of your blood stream and into your body's cells where it can be stored and used for energy. Everyone needs small amounts of insulin between meals and larger amounts when they eat.

Most People Need More Than One Kind of Insulin to Control Their Blood Glucose Throughout the Day and Night

• Short-acting insulins help the body use the glucose from the foods we eat. Many people take a needle with shorter acting insulin before each meal.
• Long-acting insulins helps keep blood glucose in the target range between meals or overnight.
• Pre-mixed insulins are a combination of short and long-acting insulins. This makes measuring insulin easier, but the pre-mixed combinations do not meet everyone's needs.

Your Doctor's Choice of the Best Insulin For Your Needs is Determined By:

• Whether you have type 1 or type 2 diabetes
• Whether you take diabetes pills
• Your schedule of sleeping, working, etc.
• Your level of activity and how much flexibility you need in your daily routine

How Can Monitoring Improve My Insulin Plan?
Monitoring shows you how your activities affect your blood glucose. You can see the effects of:

• Food choices and amounts eaten
• Insulin doses and the times when taken
• Exercise
• Stress, relaxation, and other changes in your daily routine

This information will help you and your health care team adjust insulin doses for best diabetes care.

How Will I Know if My Insulin Plan is Working?
Your blood glucose monitoring results, the frequency of high and low blood sugars, and your A1C results help tell you how well your plan is working. Ask your doctor for more detailed information on the benefits, side effects, and proper use of the insulins listed.

Insulin works differently in different people depending on factors such as injection site and amount of insulin.

Insulins in Canada (General Guidelines Only)

Levels of Glucose Control for People With Type 1 or 2 Diabetes (Adults and Adolescents)*

	A1C (%)**	Fasting Blood Glucose (mmol/L)***	2-hour Post-meal Blood Glucose (mmol/L)
Target for most patients	<7.0	4.0 – 7.0	5.0 – 10.0
Normal range (if it can be safely achieved)	<6.0	4.0 – 6.0	5.0 – 8.0

* The above information serves only as a guide. You need to know what your own blood glucose target ranges are, so be certain to discuss this with your doctor.

In addition to testing your blood glucose yourself, it is important to have a glycosylated hemoglobin (A1C) test every three to four months. This test is done in a laboratory and shows your average blood glucose levels over the past three months. Your A1C test results, along with your monitoring records, help you and your diabetes health care team know if your treatment plan is working.

When Should I Check My Glucose?
Testing at different times gives different information. Always follow your health care team's recommendations for when to test.

• Before breakfast (fasting glucose) tells whether the insulin your body makes or that you are taking is controlling blood glucose overnight
• Pre-meal glucose can help guide decisions about food and insulin for the coming meal
• Post-meal glucose tells whether you had the right amount of insulin to cover the food you ate. This is the test that helps you learn the most about your food choices.

What Should I Do With the Numbers?

If your blood glucose is above your target range:

• Review your carbohydrate intake. Did you eat more than usual?
• Review your activity. Did you get less exercise than usual?
• If food and activity were usual, review your monitoring record and diabetes medicines with your health care team.

If your blood glucose is below the target range:

• Immediately take the low blood glucose treatment your doctor or educator recommends
• Review your carbohydrate intake. Did you eat less than usual?
• Review your activity. Did you get more exercise than usual?
• If food and activity were normal, review your monitoring record and diabetes medicines with your health care team

What Are Some Tips I Should Know to Use Insulin Correctly?

• Take your insulin at the same times each day (relative to meals)
• Draw up your insulin, carefully every time to ensure getting the right dose
• Write down the exact time and amount of every insulin injection
• Learn how to balance food, insulin, and exercise. If your doctor or educator gives you a plan to change insulin doses based on your nutrition program or on your blood glucose values, use the plan carefully. Talk to your health care team before changing your insulin.
• Within an area (arm, leg, stomach, buttock), move to a different site for each shot. Each shot should be at least a thumb-width away from the last one given.
• If you are planning to exercise, inject your insulin into muscle groups not used in your activity. For example, avoid injecting into your thighs before running.