The only extensive analysis of people with diabetes is still the 1989 National Health Interview Survey. For everyone with diabetes older than 18, that survey found that 43 percent were treated with insulin, according to Chapter 25: Therapy For Diabetes in the second edition of Diabetes In America. Of course, everyone with type 1 diabetes uses insulin.

However, a large number of people with type 2 do too. “The proportion of NIDDM patients treated with insulin increased with longer duration of diabetes, from 22% at 0-4 years to 58% at more than 20 years.”

That’s why Using Insulin is not just for people with type 1 diabetes. Most people with type 2 diabetes will find themselves gladly using insulin as they get older. And like all people who use insulin, they will have many questions about how to make the best of it.

This book is the best place to turn for any of those questions. After I reviewed a draft of the book a few months ago, I wrote the authors that I consider it the bible of insulin.

The authors are lead by John Walsh, a Certified Diabetes Educator who himself has diabetes and has used a pump for more than 20 years. Listed second is John’s wife, Ruth Roberts. Together they maintain The Diabetes Mall. Two endocrinologists are also listed as authors.

This book is so up-to-date that it includes one insulin that the FDA hasn’t even approved yet. This is Novo Nordisk’s Detemir, a long-acting insulin like Lantus.

Many people will find the most valuable part of the book to be the chapters about your “Total Daily Dose” consisting of your basal dose plus your carb bolus and correction bolus. Then, you can determine your carb factor—how many grams of carb are covered by one unit of Humalog or Novolog insulin.

The general rule is that one unit of insulin covers 15 grams of carbohydrate. This rule is a rough estimate—too rough. Most people need one unit of insulin for six to 20 grams of carbohydrate, the book says. The ratio can vary, they continue, from one unit for 25 grams to one unit for every 2 grams.

This points out how individual the insulin/carb ratio is and how important it is for you to be able to calculate your own ratio. This book shows you how to do this better than anything else I know.

Using Insulin by John Walsh et al. is a trade paperback of 344 pages with a list price of $23.95. Torrey Pines Press in San Diego published it last month. [It is available at the Diabetes Mall, at Using Insulin.]