Care at NUH

Knowing Your Insulins (for People with Type 1 Diabetes)

2024/06/25

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In Type 1 Diabetes, the pancreas is unable to produce insulin, requiring insulin replacement through injections. For optimal management, individuals with Type 1 Diabetes should typically follow a basal-bolus regimen, comprising two types of insulin: 

  • Basal insulin 
  • Quick-acting (bolus) insulin 
BASAL INSULIN

Basal insulin provides a consistent background level of insulin to stabilise blood glucose levels throughout the day, including periods of fasting. 

This insulin type is generally injected once or twice daily due to its longer duration of action compared to quick-acting insulin. 

The dose typically represents 40 to 50% of your total daily insulin requirement. Incorrect dosing of basal insulin can lead to high blood glucose or hypoglycaemia, particularly if meals are missed or during sleep. Proper dosing maintains stable glucose levels (Figure 1). 

Basal insulin evaluation test

Utilise this worksheet:Overnight basal insulin evaluation worksheet.pdf under the guidance of your healthcare team to assess if your basal insulin dose is appropriate. 

QUICK-ACTING (BOLUS) INSULIN
Quick-acting (bolus) insulin, administered multiple times daily, covers insulin needs for meals and corrects high blood glucose levels. It acts rapidly and has a short duration.

Adjusting quick-acting insulin doses appropriately is vital to avoid hyperglycaemia and hypoglycaemia. Refer to the section on flexible insulin dosing for more information.  
INSULIN PUMP
Insulin pumps, battery-operated devices with a reservoir of quick-acting insulin, offer an alternative delivery method. The pump provides continuous basal insulin infusion and bolus doses as needed. Consult your healthcare team for more information about insulin pumps.
INJECTING INSULIN

For a visual guide on insulin injection using a vial or insulin pen, watch our instructional video: 

English l 岛素疗程lTerapi Insulin l இன்சுலின் சிகிச்சை 

Download a step-by-step guide for future reference here: 

How to draw and inject a mixture of two insulins from vials 

(Credit: Health Hub National Diabetes Reference Materials, accessiblehere)  

Minimise injection pain with these tips: 

  • Use insulin that is at room temperature 
  • Use a new needle for each injection to reduce pain 
  • Discuss the appropriate needle length for your needs with your healthcare team  
  • Inject the needle swiftly 

How to avoid lumps 

Regularly rotating injection sites can prevent lumps under the skin. Before injecting, feel the chosen area for lumps. If you detect any, select a different site.  

TIPS ON STORING INSULIN
  1.  Store all unopened insulin in the refrigerator, not the freezer. 
    1. Mark the date on the vial or pen when you first open it. 

    1. Keep opened vials and pens at room temperature.  

    1. Do not leave the insulin in the car or under direct sunlight. 

    1. Disposed of opened vials or pens 28 days after opening. 

    1. For cloudy insulin pens such as NovoMix, discard the pen and use a new one when less then 12 units remain to ensure adequate volume for re-suspension before injection.  

    1. If you are planning to travel, please click the following link for tips: 

    Travelling with Type 1 Diabetes 
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