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Basal insulin therapy in type 2 diabetes

Basal insulin treatment is simple and easy to start. Typically, one injection of long-acting basal insulin is added alongside other diabetes medications.

The most common insulin therapy form for type 2 diabetes is a combination therapy of basal insulin and other diabetes medications. Long-acting basal insulin prevents the inappropriate release of sugar from the liver during the night and between meals, achieving the target blood sugar level, especially upon waking in the morning.

Insulin therapy can be initiated in a health centre or elsewhere in outpatient care. The caregiver advises and demonstrates the insulin injection technique and provides guidance on using the injection devices. The dose of insulin and the number of tablets are agreed upon with the doctor. Instructions are also given on adjusting the insulin dose based on personal blood sugar measurement results.

Transitioning to a new treatment method can initially cause fear and insecurity. Many are afraid of their blood sugar dropping too low, especially since insulin is often administered before bedtime. As insulin doses are gradually increased based on blood sugar readings, excessive blood sugar drops are usually not a problem.

Basal insulin is typically started with a dose of ten units. The dose is self-adjusted based on the morning blood sugar. A simple starting guideline suitable for most is:

  • If the blood sugar in the morning before breakfast is over 7 mmol/l, increase the insulin dose by, for example, 2 units every three days until the target level is reached.

  • Your nurse and doctor will provide written instructions for adjusting the insulin dose.

There's no actual upper limit for the insulin dose, and its administration is individual – some may need ten units, while others might require over 100 units.

Updated 25.10.2023