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Insulin can be a powerful treatment to control blood glucose for people living with type 2 diabetes. There are four different types of insulin: rapid-acting insulin, regular or short-acting insulin, intermediate-acting insulin, and long-acting insulin.
Rapid-acting insulin starts working about 15 minutes after injection and peaks in about an hour with the effects lasting about two to four hours. Intermediate-acting insulin reaches the bloodstream about two to four hours after injection and peaks four to 12 hours afterwards.
Long-acting insulin starts to work several hours after injection and lowers glucose levels evenly over a 24-hour period.
Inhaled insulin starts to work within 12 to 15 minutes, peaks by 30 minutes, and is effective for around three hours. Your doctor may prescribe more than one type of insulin – a “background” (intermediate to long-acting) insulin and a “mealtime” (rapid to short-acting) insulin. Victoza is a new drug used for treating type 2 diabetes and has been found to promote weight loss in overweight and obese patients. As a treatment combined with metformin or one of the sulphonylureas among patients who suffer from a lack of glycemic control even after having tried the highest possible dose of metformin or sulphonylurea monotherapies. As a treatment combined with metformin and one of the sulphonylureas or metformin and one of the thiazolidinediones among patients who suffer from a lack of glycemic control even after having tried the dual therapy. Clinical studies with Victoza that involved the participation of over 6,500 people suffering from type 2 diabetes demonstrated a notable decrease in blood glucose levels, allowing for weight loss without the a heightened risk of hypoglycemia. The drug was first launched by Novo Nordisk – the manufacturer – within Germany, the United Kingdom, and Denmark during the summer of 2009, and throughout the second half of 2009 and throughout the year 2010 the drug will continue to be released throughout the rest of the European Union marketplaces.
The drug functions by only stimulating insulin release when the blood’s glucose levels are high enough to warrant its need. Though the drug is not considered to be weight loss medication, it does include this side effect among one of the beneficial reactions that can occur when it is used in order to control type 2 diabetes – especially in cases where weight loss is recommended by the prescribing medical professional. I have strong memories of hypoglycemia anxiety from my early days of living with Type 1 diabetes. I counsel people with Type 1 diabetes, and one of the most stressful parts of diabetes for many people is the experience of being hypoglycemic. Hypoglycemia anxiety can diminish their quality of life, and often results in an ongoing elevated blood glucose level that causes other health issues. Anxiety becomes problematic when we overestimate the dangers that surround us, and underestimate our ability to cope.  We can reduce anxiety by developing a more realistic perception of the dangers we face, and of our ability to cope with them. I have had many patients describe feeling “low” when their blood glucose readings are actually in the normal range.  Many believe this is because they are on their way to a low and will just keep dropping. For those with high levels of anxiety, it can be helpful to develop a hierarchy (list) of fears.


The nursing student starts to look at factual evidence to challenge her belief she will go low and die. If you are struggling with anxiety, or someone you care about who has diabetes is struggling with anxiety, maybe you can try some of the techniques described here. If your hypoglycaemia anxiety is so high that these ideas seem out of reach for you, then please consider accessing professional support. Michelle Sorensen is a member of the Ontario College of Psychologists and has a private practice in Clinical Psychology in Ottawa.
Having had T1D for 64 years and literally thousands of lows i was not anxious about having them.
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We use to hear something like this in our day to day life from our friends, colleagues, and home, but do you know how much this coffee affects your body, more clearly speaking how much this caffeine?
While many people start their treatment with pills, eventually, insulin may be needed to control blood glucose.
Insulin cannot be taken by mouth because digestive enzymes break it down before it reaches the bloodstream.
The types of insulin you get will depend on the type of diabetes you have, your blood sugar levels and how much your levels fluctuate throughout the day. For this reason, it is now considered to be a beneficial type 2 diabetes treatment option and helps to further reduce the risks of the condition by allowing for weight loss. Patients in my practice with very high blood glucose levels have learned to look at the evidence and develop more balanced thoughts about the likelihood of a dangerous low. This allowed her to keep her BG levels in a normal range for longer periods of time, without giving in to the impulse to snack and boost them higher to get rid of the hypoglycemia anxiety she felt.
This can be helpful when patients are becoming accustomed to a healthier range of blood glucose levels after having lived with higher readings due to the fear of hypoglycemia. For example, take some deep breaths every time you sit down to eat a meal or to catch up on email. I have met patients who have underlying worries about the long-term effects of their high blood sugar, but it just never seems like the right time to change their way of coping. Start with the most intense sources of anxiety at the top of the list and the least feared situations, events or people at the bottom.  Work your way up the list gradually, gathering evidence about your ability to confront yours fears until you are able to tackle the most intense ones on the list. Of course, all of these techniques need to be used in conjunction with support from family and health care professionals. It is a good idea to speak to your diabetes educator or endocrinologist for support and possibly referral information. My simple advice would always be avoid panic, keep packets of sugar with you always, take medicine and meals regularly, regular exercise and visit a doc monthly or quarterly.


I experienced this anxiety when first diagnosed (at 32 of T1D) partly because I had seen my mother (also T1D) have low blood sugars at a young age, when I didn’t really understand what was happening. I could have used that a few years ago ?? I really appreciate the frankness of the article, thank you! Now that i am older i get very anxious after them for an hour or so but understanding what is happening to your body helps.
Bad: Studies show that caffeine may increase cortisol secretion, which can suppress the working of immune system of the body and can lead to cardiovascular related diseases. Good: It may increase the effectiveness of many pills which are taken by the patients of migraine. Bad: Research proves that if you are taking high doses of caffeine (300 mg or higher), then it may lead to anxiety.
Peaktime is the time during which insulin is at maximum strength at lowering blood glucose. If they note that accurate carbohydrate counting and insulin dosing keeps them in safe range, coupled with testing BG regularly and carrying sources of sugar for lows, then they become more willing to gradually reduce their blood glucose levels.
You can use imagery to imagine feared events beforehand, and prepare yourself to confront them by using cognitive restructuring or relaxation methods. Unfortunately, I cannot tell her that I know for sure she is wrong.  But I can suggest we explore her underlying assumptions and figure out if this belief is very realistic.
It is important to develop confidence in her ability to cope with hypoglycemia… yes, it is best to prevent lows when possible, but she can treat the lows quickly and recover from them. If you choose to see a psychologist or social worker, I recommend someone who practices CBT, which is an evidence-based clinical approach. That pervaded into my own experience and my coping mechanism in my school life was to keep my sugars a bit higher than they should have been. Enjoyed the article but T1D is different for each person, take the time to understand what is happening to your body, it do s help with anxiaty. This can be done in conversation with a therapist or by writing down negative thoughts and challenging the thoughts using thought records (see Mind over Mood by Christine Padesky and Dennis Greenberger for a patient’s guide to cognitive behavioral therapy).
I work on gathering evidence to develop new, more balanced beliefs with patients who are overcome with anxiety about hypoglycemia. I have seen patients reduce their levels of anxiety and greatly improve their quality of life.  It is absolutely worth the effort.
I don’t care about using another test strip it if means my blood sugars are better controlled!



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