INSULIN & MEDICATION
Types of insulin, how they’re delivered, and the math behind your correction factor.
Insulin and medication are the backbone of diabetes treatment. Depending on your type of diabetes, you might use different kinds of insulin, different delivery tools, or oral medication — sometimes a combination. Here’s what they do and how they fit together.
🧭 Quick orientation
Type 1 diabetes always needs insulin — your body doesn’t make it. The insulin types and regimens below explain your options.
Type 2 diabetes is often managed with oral medication first (see the bottom of this chapter), and insulin may be added later if needed.
Insulin types — three speeds
Insulins differ in how fast they start working and how long they last. Most people on insulin use a combination.
🍎 Mealtime & corrections
- Taken before a meal
- Also used as a correction dose if blood sugar is too high between meals
- Starts working in 15–30 min
- Lasts about 4–6 hours
Examples: lispro (Humalog), aspart (Novolog), glulisine (Apidra)
🕓 NPH (intermediate-acting)
- Also called NPH insulin
- Usually injected twice a day (morning & evening)
- An older type of basal (background) insulin — used less often today, since most teens with type 1 use long-acting analog basals or pumps instead
- Has a peak a few hours after injection, which can cause lows if meals are skipped or delayed
- Starts working in 1–3 hours
- Lasts about 12–24 hours
Examples: Humulin N, Novolin N
🌙 Once-a-day basal
- Used as basal (background) insulin
- Starts working in 30 min – 4 hours, depending on the type
- Lasts 14–24 hours (longer for ultra-long-acting)
Examples: glargine (Lantus), detemir (Levemir), degludec (Tresiba)
Insulin regimens — three ways to deliver it
Your team picks a setup based on your type of diabetes, lifestyle, and what works for you.
🎒 Insulin pump
- Uses only rapid-acting insulin — no long-acting insulin needed
- Delivers a small, steady drip of that insulin all day and night to act as your basal (background) cover — the rate can be fixed or vary across the day
- The same pump delivers your mealtime and correction doses — manually or automatically
- Can offer very good blood sugar control when used carefully
💉 Basal-bolus regimen
- Traditional approach using multiple daily injections
- Long-acting insulin once a day (usually at dinner or bedtime) as your baseline
- Short-acting insulin before each meal (a bolus)
- You’ll need to count carbs and check blood sugar before meals to calculate doses
🔀 Fixed / premixed regimen
- Long-acting and short-acting insulin come premixed in one pen or vial
- Fewer injections, no pump — useful for needle anxiety or when injections at school aren’t possible
- Doses can’t be adjusted individually, so meals and routines need to stay more consistent
Examples: 70/30 (70% aspart protamine / 30% regular) · 75/25 (75% lispro protamine / 25% lispro)
🛡️ Insulin safety basics
• Never share pens, needles, or syringes — even briefly.
• Store insulin properly. If it looks cloudy when it shouldn’t, has frozen, or has been very hot, don’t use it.
• When you’re away from home, carry a backup (extra pen or fast carbs for lows).
Oral medication for type 2 diabetes
Type 2 is often managed with pills first — sometimes alongside lifestyle changes.
💊 Metformin — the usual first step
What it does: Helps your body use its own insulin better (an “insulin sensitizer”).
When it’s started: Usually as the first medication for type 2 diabetes. If HbA1c is very high at diagnosis, your team may start insulin alongside metformin until blood sugar is more stable.
How it’s taken: Started at a low dose to limit side effects (nausea, stomach pain), then increased to your target dose over 3–6 weeks.
Goal: Your team will set an HbA1c goal that’s right for you — for most teens with type 2, that’s around 7% (53 mmol/mol) or lower.
➕ If metformin isn’t enough
Your team may add basal insulin, or start a GLP-1 agonist.
GLP-1 agonists can be used in some teens with type 2 diabetes — your team will determine if you’re a candidate.
➡️ Coming up next
Need to know how to calculate a correction dose when your blood sugar is high — or what to do when it’s low? That’s covered in Managing Highs & Lows, the next chapter.
📌 Before you go
TeenHealthInsight is a health education website — not a substitute for medical advice. Any questions or worries about your medication, devices, or daily care should be brought to your doctor. Learn here, decide there — always loop in your diabetes team before changing anything you do.