Insulin Therapy in Singapore

Dr Ben Ng

Senior Consultant Endocrinologist

Dr Donovan Tay

Senior Consultant Endocrinologist

What Is Insulin Therapy?

Insulin therapy is used to regulate blood glucose levels in individuals with diabetes mellitus. It involves administering insulin to replace or supplement the body’s natural insulin production. This treatment is commonly required for individuals with type 1 diabetes and may also be prescribed for those with type 2 diabetes when other medications and lifestyle adjustments are insufficient.

How Insulin Works

Insulin is a hormone produced by the pancreas that helps cells absorb glucose for energy. In individuals with diabetes, insulin production is reduced, or the body’s ability to use insulin effectively is impaired. Insulin therapy helps maintain stable glucose levels, reducing the risk of complications such as nerve damage, kidney disease, and cardiovascular conditions.

Types of Insulin

Different types of insulin are available based on how quickly they act and how long their effects last. The choice of insulin depends on individual treatment needs, daily routines, and blood glucose patterns.

Rapid-acting insulin

Starts working within 10–15 minutes and is taken just before meals. It peaks within 1–2 hours and lasts up to 4 hours.

Short-acting insulin

Takes effect within 30 minutes, peaks in 2–3 hours, and remains active for about 6–8 hours. This type is typically taken before meals.

Intermediate-acting insulin

Begins working within 1–2 hours, peaks around 4–12 hours, and lasts up to 18 hours. It is often used to control blood glucose levels between meals and overnight.

Long-acting insulin

Provides a steady insulin level for an extended period, usually 24 hours or more, with no significant peak. It helps maintain baseline blood sugar levels throughout the day and night.

Premixed insulin

Combines rapid- or short-acting insulin with intermediate-acting insulin to provide balanced glucose control. This option reduces the number of injections required each day.

Methods of Insulin Delivery

Insulin can be administered in different ways, depending on the patient’s needs, comfort, and lifestyle.

Syringes and insulin pens: The most widely used method, allowing for precise dosing. Pens are convenient and portable, with prefilled or refillable cartridges.
Insulin pumps: Small, wearable devices that deliver continuous insulin through a thin tube placed under the skin. Pumps provide more flexibility and reduce the need for multiple daily injections.
Automated insulin delivery systems: These systems combine continuous glucose monitoring (CGM) with insulin pumps to adjust insulin delivery based on real-time glucose readings. They help maintain more stable blood sugar levels with minimal user intervention.

Who Requires Insulin Therapy?

Insulin therapy is recommended for individuals who cannot produce enough insulin naturally or whose body cannot use insulin efficiently.

Type 1 diabetes: People with type 1 diabetes require insulin therapy from diagnosis, as their pancreas does not produce insulin.
Type 2 diabetes: Insulin may be introduced when oral medications and lifestyle changes are not sufficient to control blood glucose levels. Some individuals may require insulin permanently, while others may use it temporarily during periods of increased insulin resistance, such as illness or surgery.
Other medical conditions: Insulin therapy may be required in cases of pancreatic disorders, certain hormonal imbalances, or steroid-induced diabetes.

Benefits of Insulin Therapy

Insulin therapy helps stabilise blood sugar levels and prevent complications in diabetes management.

Maintains steady blood glucose levels

Insulin prevents sharp rises and drops in blood sugar, reducing symptoms such as fatigue, dizziness, and long-term complications.
Reduces the risk of complications

Proper glucose control lowers the risk of nerve damage, kidney disease, eye problems, and cardiovascular conditions.
Enhances overall well-being

By optimising glucose absorption, insulin therapy helps reduce tiredness and improves overall quality of life.
Adaptable to different lifestyles

Insulin therapy can be adjusted in type, dosage, and delivery method to match an individual’s daily routine and glucose management goals.

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Adjusting to Insulin Therapy

Starting insulin therapy involves monitoring glucose levels, adjusting dosages, and understanding how food, activity, and medications affect blood sugar. Your doctor will provide guidance on optimising insulin regimens for stable glucose control.

Frequently Asked Questions

Is insulin therapy permanent?

Not always. People with type 1 diabetes require lifelong insulin therapy, but some individuals with type 2 diabetes may use insulin temporarily, such as during illness or surgery.

Can insulin therapy be stopped if blood sugar improves?

In type 2 diabetes, insulin may be reduced or discontinued if blood sugar can be managed through oral medications, diet, and exercise. However, individuals with type 1 diabetes require lifelong insulin therapy.

What happens if an insulin dose is missed?

The response depends on the insulin type. Some doses can be taken later, while others may require glucose monitoring and dietary adjustments.

Dr Ben Ng

Senior Consultant Endocrinologist

As a senior consultant endocrinologist with over 20 years of clinical experience, Dr Ben Ng provides comprehensive care for patients managing various endocrine conditions. His expertise includes the diagnosis and treatment of diabetes, thyroid disorders, obesity, and a range of other metabolic and endocrine conditions.

Dr Ben Ng Jen Min graduated from the Queens University of Belfast Northern Ireland, United Kingdom (UK).
He completed his postgraduate training with the certificate of completion of training (CCT) from the Royal College of Physicians (UK) with dual accreditation in diabetes and endocrinology and in general internal medicine.
In 2010, he was awarded an MD with honours by the University of Hull, UK, in recognition for his research in diabetes mellitus

Dr Donovan Tay

Senior Consultant Endocrinologist

As a senior consultant endocrinologist with over 20 years of clinical experience, Dr. Donovan Tay provides comprehensive care for patients managing various endocrine conditions. His expertise includes the diagnosis and treatment of diabetes, thyroid disorders, osteoporosis, and a range of other metabolic and endocrine conditions.

Dr. Donovan Tay graduated from the National University of Singapore (NUS) and obtained his membership in the Royal College of Physicians (UK), Master of Medicine (NUS), and Master of Clinical Investigation (NUS).
After completing training in endocrinology, he was conferred as a Fellow of the Academy of Medicine, Singapore (FAMS).
He further specialised in endocrinology with a fellowship at the prestigious Columbia University Medical Centre in New York City.

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