If you have type 1 diabetes—or if you have type 2 diabetes and oral medicines are not controlling your blood sugar—you have to take insulin. If you have gestational diabetes, you may need to take insulin if diet and exercise have not been able to keep your blood sugar levels within your target range.

With little or no insulin, sugar (glucose) in the blood cannot enter your cells to be used for energy. As a result, the sugar in your blood rises above a safe level. When your blood sugar rises past about 180 mg/dL, your kidneys begin to release sugar, which can make you dehydrated. If you are dehydrated, your kidneys make less urine, which means your body can't get rid of extra sugar. This is when blood sugar levels rise. If you can drink enough fluid to prevent getting dehydrated, you'll be able to release excess sugar in your urine.

Taking insulin can prevent the symptoms of high blood sugar and emergencies such as diabetic ketoacidosis (in type 1 diabetes) and hyperosmolar coma (in type 2 diabetes). Insulin also can help prevent serious and permanent complications from long-term high blood sugar.

Most people use insulin in an injection, or shot. It is given into the fatty tissue just under the skin. It also can be given through an insulin pump, an insulin pen, or a device that sprays the medicine into the skin (jet injector). And now skin patches are available with insulin in them, which can be worn for days. Experts are studying other ways of giving insulin, such as in an implantable pump. But this information is about insulin in syringes.

After you get past the initial anxiety, giving yourself a shot will become a routine part of your day. It's quite easy to learn the basics of drawing the insulin up into a syringe and injecting it. Although never pleasant, the sting of the injection is not bad and does not last long. More than 500,000 people do it every day. You can, too.

The three most important elements of success in giving insulin injections are:

• Making sure you have the right dose of insulin, especially if you are giving two types of insulin in the same syringe.
• Practicing how to give your injection.
• Storing the insulin properly so that each dose will work effectively.

 What does it mean to prepare and give an insulin injection?
 Why give insulin?
 How to prepare and give an insulin injection
 Where to go from here