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For people living with diabetes, understanding how insulin works, how to release insulin effectively - and when treatment is needed - can make a big difference in managing health and preventing complications with the guidance of your doctor and a healthcare team. Whether you’re newly diagnosed or supporting someone with diabetes, knowing more about insulin is a helpful step forward.

What is insulin?

Insulin, produced by beta cells, is a hormone the body needs every day. It acts as a key to unlock cells, allowing glucose to enter and be used for energy. Without it, blood sugar builds up in the bloodstream and can lead to serious complications.

A natural hormone with a vital role

Insulin, including intermediate acting insulin, is made by the pancreas, a small organ located behind the stomach. It regulates blood sugar (glucose) levels by allowing glucose from food to enter the body’s cells for energy.

Without insulin, glucose builds up in the blood. This can damage organs and lead to complications like nerve damage, kidney problems, and cardiovascular disease1.

How insulin works in the body

After a meal, blood glucose levels rise. In response, the pancreas releases rapid acting insulin, which signals cells - especially in the liver, muscles, and fat - to absorb glucose for energy or storage2.

Insulin, in conjunction with the digestive system, also helps regulate fat and protein metabolism. It has a broad influence on how the body processes nutrients.

What does insulin do?

Insulin helps move glucose from the bloodstream into cells. In diabetes, this process of regulating blood glucose levels may need support through insulin treatment.

Regulating energy and preventing complications

Insulin turns food into fuel, helping to lower blood glucose levels in the process. In people without diabetes, insulin is released in just the right amounts. In diabetes, this balance is disrupted.

Some people may need to take insulin shots or pumps to control their glucose levels. Without insulin, glucose remains in the blood, increasing the risk of complications like heart disease, vision loss, and poor healing3.

High blood sugar (hyperglycaemia) can silently damage blood vessels and nerves. This can lead to issues in the eyes, feet, kidneys, and an increased risk of stroke, especially if one has a certain medical history.

Mimicking the body’s natural process

Insulin treatment mimics the body’s natural insulin response and helps maintain blood sugar within the target range. It moves glucose into cells and lowers blood sugar to safer levels.

Modern insulin therapies are designed to follow the body’s rhythms - such as mealtime insulin (for food) and background insulin (between meals and overnight).

The difference in insulin issues for type 1 and 2 diabetes

Type 1 and type 2 diabetes both involve different types of acting insulin, but the causes differ. Understanding these differences supports better choices around treatment for diabetes.

Type 1 diabetes: no insulin production

In type 1 diabetes mellitus, the immune system attacks insulin-producing cells in the pancreas. The body produces no insulin, and treatment becomes essential4.

This form often develops in childhood or adolescence but can occur at any age. Without insulin replacement, type 1 diabetes is life-threatening due to the accumulation of extra glucose.

Type 2 diabetes: insulin resistance and gradual decline

In type 2 diabetes, the body still produces short acting insulin, but doesn’t use it effectively (insulin resistance) or doesn’t produce enough. Over time, blood sugar rises and insulin treatment may be needed5.

Type 2 diabetes can develop gradually, and many people are unaware they have it. Starting insulin is not a failure - it's part of effective diabetes care for managing a progressive condition.

Insulin treatment for type 1 diabetes

People with type 1 diabetes rely on insulin to survive. Without it, their blood sugar would rise dangerously high.

Why insulin is essential

Insulin must be taken daily. Without it (insulin), blood sugar can increase rapidly, which can lead to life-threatening complications like diabetic ketoacidosis6.

Insulin replaces a function the body has lost. It enables the body to absorb nutrients through the digestive tract and maintain normal metabolic function.

Types of insulin used

Types of insulin include:

  • Rapid-acting: works within 15 minutes, taken before meals
  • Short-acting: starts in 30–60 minutes
  • Intermediate-acting: lasts up to 8 hours
  • Long-acting: provides steady levels throughout the day and night7

Insulin types may be combined, and plans are tailored to lifestyle and health needs to support you living with diabetes.

Delivery methods and lifestyle management

Insulin can be delivered through:

  • Daily injections
  • Insulin pumps for continuous delivery

Effective management includes:

  • Timely dosing
  • Blood sugar monitoring
  • Adjusting for food, activity, and stress
  • Support from a healthcare team

With the right support, people with type 1 diabetes can live full and active lives4.

Insulin treatment for type 2 diabetes

As type 2 diabetes progresses, insulin may become necessary alongside other diabetes medicines. This is a helpful and effective part of care - not a sign of failure.

When lifestyle and tablets aren’t enough

Initially, type 2 diabetes is often managed through diet, exercise, and medication. But over time, these may not control blood sugar. Insulin treatment may then be needed5.

This step reflects the natural progression of diabetes - not personal failure.

Different approaches to insulin therapy

Options include:

  • Basal insulin (long-acting)
  • Bolus insulin (rapid-acting) with meals
  • Combination therapy with oral medications

Dosing is tailored to the individual. Some people may begin with a single daily injection, while others may need more frequent doses.

Starting with insulin is not a failure

Many worry that starting insulin means their diabetes is worsening8. In fact, insulin can help preserve pancreatic function and prevent complications.

It’s a proactive way to improve blood sugar control and protect long-term health.

Does insulin resistance lead to diabetes?

Insulin resistance isn’t diabetes, but it raises the risk. If unmanaged, it can progress to type 2 diabetes.

Understanding insulin resistance

When cells stop responding well to insulin, the pancreas produces more to compensate. Over time, this demand can overwhelm the pancreas9.

How insulin resistance develops

Insulin resistance often develops gradually, influenced by acting insulin and other factors.

  • Excess weight (especially around the waist)
  • Inactivity
  • Diet high in refined carbs and saturated fats
  • Family history of diabetes
  • Conditions like PCOS or metabolic syndrome

Other factors include hormonal changes and poor sleep10.

Early signs and intervention

Signs of insulin resistance can include:

  • Tiredness after meals
  • Sugar cravings
  • Weight gain, especially around the middle
  • Dark skin patches (acanthosis nigricans)

Lifestyle changes like managing your diabetes with exercise, weight loss, and healthier eating can reverse insulin resistance and delay insulin diabetes progression11.

Accepting insulin treatment

Starting insulin can feel like a big step, but it can also bring significant health benefits. Many people feel unsure, but insulin often brings more stability, not less.

Breaking down emotional barriers

It’s common to feel nervous about starting insulin for diabetes. Some people view it as a setback, but insulin is a natural next step in managing a chronic condition8.

Reframing insulin as a positive step

Insulin lowers blood sugar, reduces complications, and supports a more energetic lifestyle2. It's a tool for improving health - not a sign of failure.

Insulin injections are prescribed for treatment of both type 1 and type 2 diabetes based on changing needs - not on success or failure.

Building confidence with education and support

Starting a new routine can be challenging, but support helps. With education and practice, insulin therapy becomes manageable.

Supportive steps include:

  • Learning how insulin works and how to use it
  • Talking to your care team
  • Using insulin pens or pumps
  • Connecting with support groups

Many find insulin quickly becomes part of everyday life.

Embracing change, gaining control

Accepting insulin is not giving in - it’s taking control. It allows people to live well, meet goals, and protect long-term health.

Modern insulin treatment, including premixed insulin, is flexible and tailored to the individual. Whether rapid-acting or long-acting, the aim is the same: better control, fewer complications, and more confidence.

FAQs

How does insulin work?

Insulin is a hormone that helps regulate blood sugar levels. After you eat, it allows glucose from food to enter your body’s cells, where it’s used for energy or stored for later use. Without enough insulin, glucose stays in the bloodstream, leading to high blood sugar. Insulin therapy helps keep levels within a healthy range.

Can I avoid having to take insulin?

In some cases, especially with type 2 diabetes, insulin can be avoided or delayed through healthy lifestyle changes, such as eating well, exercising regularly, maintaining a healthy weight, and taking prescribed oral medications. However, if blood sugar levels remain high despite these efforts in clinical diabetes, insulin may become necessary. It’s not a failure - it’s a helpful tool to protect your long-term health.

Can I get insulin through my diet?

No, you cannot get insulin directly through your diet. Insulin is a hormone produced by the pancreas and cannot be absorbed from food. While a healthy diet can help manage blood sugar levels - especially in type 2 diabetes - it cannot replace insulin. People who need insulin must take it through injections or an insulin pump as prescribed by their doctor.

Managing type 1 diabetes

What is type 1 diabetes?

What is type 1 diabetes?

Understanding the difference between type 1 and type 2 diabetes and recognizing the common symptoms of type 1 diabetes.

GLP 1 treatment and how it works

GLP 1 treatment and how it works

Glucagon-like peptide 1 (GLP-1) is a naturally occurring hormone in the body. Although its production is inhibited in people with type 2 diabetes, its function remains possible.

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Learn more about living with diabetes and your treatment options

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Life changes after being diagnosed with type 2 diabetes. There will  be new routines and habits that are important to ensure good health and avoid serious complications down the line.

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Diabetes is a lifelong disease that affects the body’s ability to convert glucose from food into energy. In most cases, type 1 diabetes develops early in life and is often diagnosed during childhood, while type 2 diabetes often sets in later in life1.

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Insulin treatment has evolved significantly, and with each advancement, we are closer to a natural insulin response. This has contributed to improving the quality of life and life expectancy of people living with type 1 diabetes7 .


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References
  1. Diabetes UK. Complications of Diabetes. Available at: https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/complications (Accessed: 26 June 2025)
  2. Diabetes UK. What is insulin?. Available at: https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments/insulin/what-is-insulin (Accessed: 26 June 2025)
  3. Home, P. D. (2013). Insulin therapy in people with type 2 diabetes: opportunities and challenges? Diabetes Care, 36(Supplement 2), S113–S120. doi: 10.2337/dc13-2743
  4. NHS. Type 1 Diabetes. Available at:  https///www.nhs.uk/conditions/type-1-diabetes/what-is-type-1-diabetes/ (Accessed: 26 June 2025)
  5. NHS. Type 2 Diabetes. Available at: https/www.nhs.uk/conditions/type-2-diabetes/what-is-type-2-diabetes (Accessed: 26 June 2025)
  6. NHS. Complications of type 1 diabetes. Available at: https://www.nhs.uk/conditions/type-1-diabetes/complications/ (Accessed: 26 June 2025)
  7. Thota, S., (2023). Insulin. National Center for Biotechnology Information (NCBI) Bookshelf. Available at: https://www.ncbi.nlm.nih.gov/books/NBK560688 (Accessed 26 June 2025)
  8. Peyrot, M., et al. (2005). Resistance to insulin therapy among patients and providers: results of the DAWN study. Diabetes Care, 28(11), 2673–2679. doi: 10.2337/diacare.28.11.2673
  9. Dludla, P.V. et al., 2023. Pancreatic β-cell dysfunction in type 2 diabetes/ Implications of inflammation and oxidative stress. Frontiers in Endocrinology, Available at:  https://pmc.ncbi.nlm.nih.gov/articles/PMC10075035/ (Accessed 26 June 2025)
  10. Singh, T., et al, 2022. Does insufficient sleep increase the risk of developing insulin resistance: A systematic review. Cureus. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9036496/ (Accessed 26 June 2025)
  11. Diabetes UK. Insulin Resistance. Available at: https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments/insulin/resistance (Accessed 26 June 2025)