The simple answer to that question is “yes!” Sometimes the dose of insulin you need to take to lower your blood sugar is higher than your insulin pen or syringe can deliver. When this happens, it is really important to talk with your healthcare professional about how to manage your insulin dose. However, new products will soon be on the market that are going to make insulin dosing a lot easier!
Insulin therapy is an integral part of managing both type 1 and type 2 diabetes, and we are learning more all the time about how to adequately dose insulin to achieve optimal glucose control. For example, in type 2 diabetes, we know that we should ensure we get the maximum effect we can from basal (background) insulin before we move to bolus (mealtime) insulin. Sometimes, the insulin dose can be up to 1 to 2 units per kg per day; so, if you weigh 100 kg, you might need to take 100 to 200 units each day to reach your blood glucose target.
Help is on the way
Several insulin companies have recognized the need to deliver higher amounts of insulin in lower volumes. Currently, all insulin in Canada is composed of 100 units of insulin for every 1.0 mL (also known as U-100 insulin). On the horizon are new, concentrated formulations of insulin glargine (Lantus) U-300 (300 units of insulin for every 1.0 ml), NPH insulin U-200 (200 units for every 1.0 mL) and insulin lispro (Humalog) U-200 (200 units for every 1.0 mL). Also in development is a basal insulin, called insulin degludec (Tresiba); when approved in Canada, it will be available in both U-100 and U-200 formulations.
What do you need to know?
Most importantly, these insulins are being developed to address the increasing need for more insulin per day to manage diabetes. Increasing the concentration and reducing the volume will allow us to give more insulin at each dose with less volume. This will lead to improved absorption of insulin and will be less damaging for injection sites.
These new insulins will all come in pre-filled devices, clearly labeled with the type of insulin inside the pen, and a unit dialed will be a unit given. Neither you nor your healthcare team will have to worry about doing any fancy calculations regarding how much to give: the pen will take care of that! What is extremely important to remember, though, is that when using these insulins (once they’re available), you must never use a syringe to draw from the pen cartridge, since this could lead to a serious overdose of insulin.
Is your insulin dose too high?
Your insulin regimen is individualized to you with the goal of achieving your glucose target. Whichever dose of insulin you need to take to achieve your target is the dose that is right for you. Everyone will have different insulin doses, because everyone’s diabetes management is different. What is important is that with these forms of concentrated insulins that are on the horizon, you will be able to take a large dose in a smaller volume, and that’s good for both your blood sugar levels and your injection sites!