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If this is a sudden change in his mental status, i.e., a sudden onset of paranoia,call his doctor immediately. He may have a UTI or another acute infection which could be causing this.
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Where's dad living? If at home, it's time to look into placement in Memory Care Assisted Living where his meds will be administered to him every day. Dementia often reaches a point where managed care becomes the only viable option, along with calming meds to help with agitated paranoia.

You have no profile filled out, so it's hard to offer advice w/o knowing your situation.
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Are you taking care of him at home?

Sometimes a difficult client will respond better if a “nurse” comes to administer meds.

”Paranoid” is often part and parcel with dementia.

Could his insulin be administered in a different form than he’s currently refusing?

Have you discussed his situation with the medical source who writes his insulin ??

As you can see, there’s no “best” answer, but hopefully you’ll wind up with lots of suggestions here.

Good luck!
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I took over organizing my mother’s meds (a mix of prescription and nonprescription) about 5 years ago, and soon had to supervise her taking them 4x per day. If something was different, she’d fight me. Her dementia was bad enough that she couldn’t count nor make sense of the days of the week. My mother is now in care and I am slowly going through her house. I cannot believe what I am finding! Pills everywhere! Single pills dropped into vases, mugs, envelopes, even a row lined up behind a tabletop picture frame and another row inside a cupboard... it’s truly disturbing! I (or occasionally my husband or a PSW) supervised her taking them! Definitely talk to a Dr about calming the paranoia and checking for infections.
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