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Insulin

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WHAT IS IT?

Abstract

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.

 

 

HYPOGLYCAEMIA
- 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.

 

 

DIABETIC COMPLICATIONS
- 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.

 

 

STORAGE
- 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.

 

 

WEBSITES
Children With Diabetes (US):

 

 

www.childrenwithdiabetes.com/

 

 

d_0n_110.htm

 

 

Diabetes Insight:

 

 

www.diabetes-insight.info

 

 

Diabetes UK:

 

 

www.diabetes.org.uk

 

 

Insulin Dependent Diabetes Trust:

 

 

www.iddtinternational.org.uk

 

 

NHS Direct:

 

 

www.nhsdirect.nhs.uk

 

 

Nottingham Diabetes:

 

 

www.nottinghamdiabetes.nhs.uk/insulin.html

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