Skip main navigation

£199.99 £139.99 for one year of Unlimited learning. Offer ends on 28 February 2023 at 23:59 (UTC). T&Cs apply

Find out more

Carlos: insulin treatment options

Carlos considers different treatment regimens at 25 years of age
© University of Southampton

Carlos is now 25. As Carlos transitioned from the young person’s clinic to the adult diabetes clinic, he was offered a choice of how he wished to use insulin as an adult.

The treatment regimen choices were to either inject a mixed insulin twice daily, or to use two different insulins each day.

He asked for information on each regimen.

Using ‘mixed’ insulin

Injecting insulin twice daily would mean administering mixed insulin with breakfast and the same type of mixed insulin before his evening meal.

With a mixture, the fast component of the mixture would cover blood glucose levels over breakfast and evening meals, whilst the slower component would provide glucose cover between meal times.

Though only two injections, Carlos would have to eat at a similar time each day and ensure that his meal content was fairly consistent.

Twice daily mix insulin graph with circulatory insulin level on the Y-axis and a 24 hour period on the x-axis. There are two peaks in the circulatory insulin level. Figure: twice daily mix insulin graph

Using two different types of insulin

Injecting with two different insulins gives increased flexibility in terms of meal timings.

There would be the need to inject a long acting insulin once daily, at a similar time each day, to provide constant ‘background’ cover for blood glucose levels.

To cover the spikes in blood glucose following a glucose containing meal, a rapid or fast acting insulin is administered before a meal. The timings of the meals can be varied, as long as the insulin is given just before in all cases.

This method of delivering insulin known as the basal-bolus regimen and is close to the normal physiological release of insulin in response to glucose from a meal.

Basal-bolus therapy graph with circulatory insulin level on the y-axis and 24 hours on the x-axis. A red line shows the background level of insulin with a blue showing the peaks throughout the day. Figure: basal-bolus therapy graph

As Carlos works shifts, and his mealtimes vary from day to day, what do you think he might do? What other considerations do you think Carlos might take into account when making his decision about which insulin treatment option to go for?
© University of Southampton
This article is from the free online

Understanding Insulin

Created by
FutureLearn - Learning For Life

Our purpose is to transform access to education.

We offer a diverse selection of courses from leading universities and cultural institutions from around the world. These are delivered one step at a time, and are accessible on mobile, tablet and desktop, so you can fit learning around your life.

We believe learning should be an enjoyable, social experience, so our courses offer the opportunity to discuss what you’re learning with others as you go, helping you make fresh discoveries and form new ideas.
You can unlock new opportunities with unlimited access to hundreds of online short courses for a year by subscribing to our Unlimited package. Build your knowledge with top universities and organisations.

Learn more about how FutureLearn is transforming access to education