If you have type 2 diabetes you have probably started treatment with oral medications. Over the years the ability of your pancreas to make insulin declines by average 4% per year. You may have added 2 or 3 or 4 different medicines to keep the blood sugars under control. At some point, your doctor may suggest that you start insulin. One good thing about insulin is that it is natural to your body and it always works.
Here is a simple protocol for starting insulin and adjusting it to get good control of the blood sugars throughout the day. You could start using a basal insulin (Tresiba, Lantus, Basaglar, Levemir) which is active all day and night. This may be all the insulin that you will need for a long time. The dose can be increased until the fasting blood sugar is under 120. That will give you a good “base” to work from.
Once the fasting blood sugar is under control with a basal insulin then you can proceed through the day. You can start adding insulin at mealtimes. You may not need insulin at every meals. We are most resistant to insulin and need the most additional insulin in the morning. If the blood sugar 2 hours after breakfast jumps to >140-180 then you could add some rapid acting insulin (Humalog, NovoLog, Apidra, Fiasp) before breakfast. Once the blood sugar after breakfast is controlled then a similar process could be used to control the blood sugar after dinner and after lunch. Sometimes only one or 2 doses of mealtime insulin is needed.
If the newer insulins are too expensive for your budget then some people will use NPH (N) twice per day in the morning and at bedtime instead of basal insulin and regular (R) before meals.
Every patient is different. The combinations of insulin and oral medications need to be customized for the individual. It may take many small steps to reach the optimum regimen for you. There is good evidence that getting blood sugars under control will eliminate.