Diabetes: Insulin Lispro

Insulin lispro (brand name: Humalog) is a fast-acting insulin that starts working more quickly than other types of insulin. It reaches peak activity (the point at which it is most effective) within 1 to 2 hours and leaves your body after 3 to 4 hours. Other fast-acting insulins (insulin glulisine [brand name: Apidra] and insulin aspart [brand name: Novolog]) are also available.

Your body changes most of the food you eat into a form of sugar. Insulin helps this sugar enter all of the cells in your body to be used as energy. If your body doesn't produce enough insulin or the insulin you have doesn't work properly, sugar builds up in your blood stream instead of moving into your cells. This causes a high blood sugar level. Insulin lispro helps keep your blood sugar levels from going too high after you eat.

To keep your blood sugar levels steady throughout the day, your doctor will prescribe either a longer-acting insulin or another drug for you to take each day in addition to insulin lispro.

Insulin lispro should be injected no more than 15 minutes before you eat. Your doctor will tell you how much insulin lispro to inject. Remember, you should not wait more than 15 minutes to eat after you take this insulin shot.

Insulin lispro can be more convenient to take than regular insulin. With regular insulin, you inject the insulin and then wait 30 to 45 minutes before eating. Many people find it hard to time their meals around regular insulin injections. Sometimes they end up eating too early or too late. Then they don't get the best blood sugar control. Since insulin lispro is taken so close to meals, it may help you get better blood sugar control.

It's best that you mix insulin lispro only with Humulin U or Humulin N, which are brand names for certain longer-acting insulins. Insulin lispro should always be drawn into the syringe first. This will keep the longer-acting insulin from getting into the insulin lispro bottle. After mixing insulin lispro in the same syringe with Humulin U or Humulin N, you must inject the mixture under your skin within 15 minutes. Remember to eat within 15 minutes after the injection.

You may take insulin using a syringe that you fill from a vial or using a dosing pen that contains the insulin. To prepare a dose of insulin lispro using a syringe, follow these steps:

If your insulin lispro comes in a pen, your doctor or his or her office staff can show you how to use it correctly. Follow the directions carefully.

Insulin lispro is injected just under the skin. Your doctor or his or her office staff will show you how and where to give an insulin injection. First, clean your skin with cotton dipped in alcohol (PICTURE 2, top). Most people are able to grab a fold of skin and inject insulin at a 90-degree angle (PICTURE 2, bottom; PICTURE 3). If you're thin, you may need to pinch the skin and inject the insulin at a 45-degree angle (PICTURE 4). When the needle is in your skin, you don't need to draw back the syringe plunger to check for blood.

The usual places to inject insulin are the upper arm, the front and side parts of the thighs, and the abdomen (tummy area). Don't inject insulin closer than two inches from your belly button.

To keep your skin from thickening, try not to inject the insulin in the same place over and over. Instead, change injection places. But if you usually inject insulin into your arm, just inject in different spots on your arm rather than switching to the thigh or abdomen. This works better because insulin is absorbed at different rates from your arm, your thigh and your abdomen.

"Hypoglycemia" is the name for a condition in which the blood sugar level is too low. If you use insulin, your blood sugar level can get too low if you exercise more than usual, if you don't eat enough, if you don't eat on time or if you take too much insulin. If you have an insulin reaction, you may feel some or all of the following symptoms: headache, nervousness, shakiness, heavy sweating, rapid heartbeat, hunger, confusion or dizziness. Most people who take insulin have insulin reactions at some time.

If you're going to use insulin lispro, you need to be aware of insulin reactions and how to treat them. Insulin lispro acts quickly. So while you and your doctor are working to find the right dosage of this insulin, you may have some insulin reactions.

Just in case you have an insulin reaction, you should carry at least 15 grams of a fast-acting carbohydrate with you at all times. The following are examples of quick sources of energy that can relieve the symptoms of an insulin reaction:

If you don't feel better 15 minutes after having a fast-acting carbohydrate, or if monitoring shows that your blood sugar level is still too low, have another 15 grams of a fast-acting carbohydrate.

Teach family members and friends how to give you a drug called glucagon in case your blood sugar level is too low and you can't treat yourself. Glucagon comes as a powder and a liquid that must be mixed together. Then the mixture has to be injected. Talk to your doctor to learn when and how to use glucagon.

You need to check your blood sugar level regularly using a blood glucose monitor. Your doctor or his or her office staff can teach you how to use the monitor. You'll need to write down each measurement and show this record to your doctor. He or she will use this information to decide how much insulin is right for you.

Blood sugar measurements are affected by stress levels, how much you exercise, how fast you absorb your food, and hormonal changes related to things like puberty, menstrual cycles and pregnancy. Illness, traveling or a change in your routine may mean that you have to monitor your blood sugar level more often.