WHAT IS IT?
VOL: 100, ISSUE: 8, PAGE NO: 29
WHAT IS IT?
- Insulin is a peptide hormone secreted into the blood by the islets of Langerhans of the pancreas.
- It was discovered in the early 1920s by a Canadian team led by Frederick Banting.
WHAT DOES IT DO?
- Insulin has three main functions:
- It allows glucose to pass into cells for use as energy;
- It suppresses excess production of sugar in the liver and muscles;
- It suppresses the breakdown of fat for energy.
- The inability to produce sufficient insulin is known as diabetes mellitus.
- There are two types of diabetes:
- Type 1 in which little or no insulin is produced and usually appears before the age of 40;
- Type 2 is often called maturity-onset diabetes. It usually occurs after the age of 40 and is linked with obesity.
TREATMENT OF DIABETES
- Treatment focuses on maintaining acceptable blood glucose levels to prevent hypoglycaemia or hyperglycaemia.
- The ideal blood glucose level varies with age, sex and lifestyle.
- Type 1 diabetes is treated with insulin injections, diet and exercise, all monitored by frequent checks of blood glucose levels.
- Type 2 diabetes can normally be controlled by a combination of diet, exercise and oral hypoglycaemic drugs but if severe, insulin injections may be required.
- Diabetic hypoglycaemia is generally caused by administering too much insulin or eating too little food for the amount of exercise taken.
- It can cause a range of warning symptoms, including shakiness, sweating, pallor, tachycardia, confusion and irritability. Some people stop having these warnings due to long-term diabetes, repeated hypoglycaemia, neuropathy, change in insulin formulation or long-term use of human insulin.
- Severe untreated hypoglycaemia can lead to coma, seizures and death.
- Consistently high blood glucose can lead to increased risk of a range of serious complications in the long term such as microvascular complications including retinopathy, nephropathy, proteinuria and neuropathy.
TYPES AND DELIVERY OF INSULIN
- Insulin used to treat diabetes can come in three preparations: human sequence (created by modifying porcine insulin using enzymatic or recombinant DNA methods), porcine or bovine, although bovine is seldom used.
- It is available in a number of formulations, classified by their onset of action:
- Those with a relatively rapid onset of action;
- Those with intermediate action;
- Those with a slower onset of action but which last for longer periods.
- Patients are prescribed insulin according to individual needs and may require a mixture of different types for different times of the day.
- Insulin is generally given by subcutaneous injection into the thighs, buttocks, or abdomen.
- Most patients now use injection pens, although some still prefer a conventional syringe and needle.
- Unopened insulin vials should be stored in a refrigerator.
- Freezing can destroy insulin.
- Open insulin, whether in vials or in pens, can be safely kept at room temperature for up to one month.
Children With Diabetes (US):
Insulin Dependent Diabetes Trust: