What is the effect of 2 units of insulin on blood glucose levels?

From the Guidelines

2 units of insulin can lower blood sugar by approximately 30-50 mg/dL (1.7-2.8 mmol/L) in individuals with normal insulin sensitivity, but this effect can vary significantly between individuals. This variation is due to several factors including insulin sensitivity, body weight, time of day, physical activity level, and concurrent illness 1. Each person has their own insulin sensitivity factor (ISF), which determines how much one unit of insulin will lower their blood glucose. For some people with high insulin sensitivity, 2 units might lower blood sugar by 100 mg/dL or more, while others with insulin resistance might see minimal effect.

To determine your personal insulin sensitivity, it is crucial to work with your healthcare provider to establish your ISF through careful monitoring of blood glucose responses to insulin doses 1. This information is vital for safe insulin dosing and avoiding dangerous hypoglycemia. Never adjust insulin doses without medical guidance, as incorrect dosing can lead to severe hypoglycemia or hyperglycemia.

Some key points to consider when adjusting insulin doses include:

• Using a simplified sliding scale, such as giving 2 units of short- or rapid-acting insulin for premeal glucose >250 mg/dL (13.9 mmol/L) 1
• Adjusting insulin dose and/or adding glucose-lowering agents based on fingerstick glucose testing performed before lunch and before dinner
• Goal: 90–150 mg/dL (5.0–8.3 mmol/L) before meals; may change goal based on overall health and goals of care 1
• If 50% of premeal fingerstick values over 2 weeks are above goal, increase the dose or add another agent
• If >2 premeal fingerstick values/week are <90 mg/dL (5.0 mmol/L), decrease the dose of medication 1.

It is essential to prioritize individualized care and work closely with a healthcare provider to determine the best approach for managing blood sugar levels with insulin therapy.

From the Research

Blood Sugar Reduction

• The reduction in blood sugar levels due to a 2-unit drop of insulin is not directly stated in the provided studies 2, 3, 4, 5, 6.
• However, the studies discuss the effects of different types of insulin and GLP-1 receptor agonists on blood sugar levels in patients with type 1 and type 2 diabetes.
• For example, a study on GLP-1 receptor agonists found that long-acting GLP-1 RAs can reduce HbA1c levels by -6 mmol/mol (95% CI -10; -2) and fasting plasma glucose by -0.7 mmol/L (-1.2; -0.3) when used in combination with basal insulin 5.
• Another study on biosynthetic human insulins and analogs discusses the need for faster-acting insulins to mimic normal physiology and improve control of postprandial glycemic excursions 4.

Insulin Sensitivity

• A study on the correlation between dose-response to rapid- and long-acting insulin in individuals with type 1 diabetes found a weak correlation between insulin sensitivity to rapid- and long-acting insulin across individuals 2.
• This suggests that the response to insulin can vary significantly between individuals, making it difficult to predict the exact reduction in blood sugar levels due to a 2-unit drop of insulin.

GLP-1 Receptor Agonists

• GLP-1 receptor agonists have been shown to be effective in reducing HbA1c levels, fasting plasma glucose, and body weight in patients with type 2 diabetes 3, 5, 6.
• Long-acting GLP-1 RAs appear to be more effective than short-acting GLP-1 RAs in reducing HbA1c levels and body weight, and have a lower risk of gastrointestinal side effects 5, 6.