Insulin and Diabetes

Insulin is a hormone that allows glucose to move from the blood into the body's cells to be used for energy. People with type 1 diabetes cannot make insulin and need it every day to live. Some people with type 2 diabetes also need insulin when other treatments are no longer enough. This lesson explains how insulin works, who uses it and why, and why the dose is carefully set by the person's doctor or diabetes team. Key points: insulin is a high risk medicine, the dose and timing are individual, and only the prescriber can change them.

There are several types of insulin, grouped by how quickly they start working and how long they last. This lesson describes, in general terms, rapid acting and short acting insulin, usually given with meals, intermediate and long acting insulin, which provide background cover, and premixed insulin. It also describes the devices used to give insulin: pens, vials and syringes, and insulin pumps, along with continuous glucose monitors. Key points: many people use more than one type, the timing of each type matters, names can look similar, and you must always check the exact insulin in the person's plan.

Insulin is damaged by heat, freezing and direct sunlight, and damaged insulin may not work. This lesson covers how to store insulin safely: unopened insulin is kept in the fridge, usually between 2 and 8 degrees, until its expiry date, and never frozen; insulin in use is usually kept at room temperature below 25 degrees and used within about a month, depending on the product. Key points: label pens or vials with the date opened, check expiry dates and appearance, keep insulin out of hot cars and sunlight, carry it in an insulated pack when out, and follow the product information and pharmacist advice.

The level of support a person needs with insulin varies, from reminders and supervision to full administration by a trained worker. This lesson explains how to support insulin safely within the person's diabetes management plan, medication chart and our medication policy. It covers the rights of safe medication support, checking glucose before insulin if the plan says to, supporting independence, sharps safety and recording. Key points: only support insulin if you have been trained and assessed as competent for that participant, never change a dose, never share equipment, dispose of needles in a sharps container, and record every dose.

Hypoglycaemia, or a hypo, is the most common risk of insulin. It happens when blood glucose falls below 4 mmol/L, for example after too much insulin, a missed or delayed meal, extra activity or alcohol. This lesson covers the signs and the response. If the person is awake and can swallow, give about 15 grams of fast acting carbohydrate, recheck in 10 to 15 minutes and repeat if still low, then give longer acting carbohydrate. If they are drowsy, unconscious or cannot swallow, give nothing by mouth, place them on their side and call 000. Glucagon is only given by workers trained for that person.

Insulin errors can be serious, so it is important to recognise and report them quickly. This lesson covers common errors, such as a missed dose, a double dose, the wrong insulin or the wrong time, and what to do: make sure the person is safe, monitor for hypo or hyper signs, seek advice from the doctor, pharmacist or a health advice line as our policy says, call 000 if the person is unwell, tell your team leader and complete an incident report. Key points: never try to fix an error by changing the next dose yourself, be honest and report straight away, and remember this course builds knowledge only.

This case study follows Josefa, an older man with type 2 diabetes who has rapid acting insulin before lunch at his day program. After his insulin, he says he feels queasy and does not want to eat. The lesson shows how his support worker recognises the hypo risk, follows his plan, offers alternatives, checks his glucose, treats a hypo correctly and reports what happened. Key points: rapid acting insulin must be matched with food, treat hypos fast, and follow the plan. This course builds knowledge only; you must be trained and assessed for each participant.

This case study follows Ngozi, a woman with type 1 diabetes who uses a long acting insulin at night and a rapid acting insulin with meals. A worker who is new to her gives the rapid acting pen at bedtime instead of the long acting one. The lesson shows how to respond to an insulin error: keep her safe, watch closely, get advice, tell the team leader, and never try to fix it alone. It then looks at how the team learns from the error without blame, by making the two pens easier to tell apart.