Doctor Discussion Guide: Switching Long-Acting Insulins

If you’re taking insulin for type 2 diabetes, it’s because your pancreas can’t produce enough of this hormone, or your cells can’t use it efficiently. Taking insulin through injection helps replace or add to the insulin your pancreas makes to control your blood sugar.

As its name suggests, long-acting insulin controls your blood sugar for an extended period — about 12 to 24 hours. It keeps your blood sugar levels steady during periods when you’re not eating, such as overnight or between meals.

At some point in your treatment, you or your doctor might decide that you need to switch to a different brand of long-acting insulin. There are a few reasons for making the switch:

  • Your sugars aren’t controlled on your current brand of long-acting insulin or your sugars are very variable.
  • The brand you currently used is no longer being produced.
  • Your current brand is temporarily unavailable.
  • The cost of your brand has increased, and you can no longer afford it.
  • Your insurance covers a different kind of insulin.

Although all insulin generally works the same, a few issues can arise when you change to a new brand. Here are a few things to talk to your doctor about before you make the switch.

Monitor your blood sugar levels

Changing your insulin can alter your blood sugar control for a few days or months. You will likely need to test your blood sugar more often until your body gets used to the new insulin. Ask your doctor how often and when to test.

If the dose of your new insulin is too high, you could develop low blood sugar (hypoglycemia). Besides testing your blood sugar more often, report these symptoms to your doctor:

  • dizziness
  • blurred vision
  • weakness
  • fainting
  • headache
  • jitteriness or nervousness
  • fast heartbeat
  • confusion
  • shakiness

Changes in your blood sugar control can mean that you have to adjust your insulin dose or the timing of each dose. Keep careful track of your blood sugar levels each time you test. You can write them in a journal, or use an app like MySugr or Glooko.

Ask about how your new insulin works, and how and when to take it

All long-acting insulin works in generally the same way. But different brands can have slight differences in how quickly they work, whether they have a peak, and how long their effects last. These differences might affect when you give yourself insulin, and how soon you can expect to see your blood sugar levels respond.

A typical dosing schedule involves taking long-acting insulin once or twice a day. You might also have to take rapid-acting insulin before meals and as needed to bring down high blood sugar levels. The proper combination of long-acting and short-acting insulin is important to control your sugars throughout the day and night.

Don’t assume that you know how to take the new insulin brand just because you’ve been on long-acting insulin for a while. For example, you must shake some brands of insulin before administering. Others don’t need to be shaken. Ask your doctor and pharmacist for clear instructions, and follow the directions that come with your insulin.

Ask about side effects

All insulin is typically the same, but there can be minor differences in how they are made. Although rare, it’s possible you may have an allergic reaction or side effects from your new medicine that you didn’t have with the old one.

Ask your doctor what symptoms to watch out for. Signs of a reaction include:

  • redness, swelling, or itching at the injection site
  • nausea and vomiting

Reactions at the injection site are usually mild and should go away on their own. Ask how long side effects should last, and when they’re serious enough to call your doctor.

Discuss the costs

Before switching to a new long-acting insulin brand, find out if your insurance company will cover the cost of your new insulin. If you have to pay any amount out of pocket, find out how much. Some brands are less expensive than others.

Work with your doctor

Whenever you make any changes to your treatment, your doctor is a valuable resource and has your best interest at heart. Go to all your appointments, follow your doctor’s advice, and don’t be afraid to ask questions if anything isn’t clear. Your doctor will work with you to make sure you’re on the safest and most effective diabetes treatment plan and help address any problems you face along the way.

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