Insulin is a hormone produced by the human pancreas to regulate blood glucose and to have an effective energy supply to all our body tissues.
- What is the role of insulin in our body ? When food is ingested it travels down the digestive tract and broken down into nutrients in order to be absorbed into the blood stream. One such nutrient is glucose. Glucose gets absorbed by the stomach and intestines. Then enters the blood stream. It travels through circulation to all body cells. Once in blood stream blood glucose rises. The increased blood glucose sends signals to the pancreatic beta cells which respond by secreting the hormone insulin. Insulin helps glucose to reach specific target tissues of the body like liver,muscles and adipose tissues. Insulin keeps blood glucose levels stable in the body .
- Is insulin administration necessary in all diabetics ? It has to be administered in type 1 diabetes and in certain type 2 diabetics as well. Type 2 diabetics undergoing major surgery, having major infections, diabetes in pregnancy and diabetics having weight loss , ketoacidosis are some individuals of type 2 diabetes requiring insulin. Those with long standing type 2 diabetes will all require insulin because of failure of pancreas to produce adequate insulin.
- In type 2 diabetes is insulin necessary throughout life? In most patients with longstanding diabetes insulin is required on long term basis. It may be withdrawn if the patient is able to abide by strict life style changes that include weight reduction, exercises and proper diet in selected cases.
- How to store insulin? Keep your insulin away from heat and light. Never let your insulin freeze. If it freezes do not use it even if it is thawed . Keep unused insulin bottles, cartridges and pens in the refrigerator between 36 and 46 degree Fahrenheit. Keep insulin cartridges and pens that you are currently using at room temperature between 56 and 80 degree Fahrenheit. The vial is warmed by rolling it in between the fingers of both hands.
- What are the travel tips for insulin? Protect insulin from getting too hot or cold. Too hot is above 80 and too cold is below 36 degrees Fahrenheit. Don’t leave insulin in your parked car as it may get too warm. While traveling by bus, train or plane keep your insulin, other medicines and diabetes supplies in a carry on bag. To get through airport security carry doctors prescriptions and keep insulin in original packaging.
- Where is insulin administered? It is given under the skin and is almost painless.The preferred sites are on the abdomen 3 cms away from the navel, the front of the thigh and on the arm.Preparation of skin with alcohol is longer advisable as long as the skin is clean.Rotation of sites is advisable to prevent lipodystrophy and delayed absorption.
- What are the possible complications of insulin therapy? Hypoglycaemia is the most important complication. Either lack of adequate food intake or excess dose of insulin is the main factor.Sweating, dizziness, tremors, irrelevant talk, lack of consciousness, poor visibility , focal tremors , convulsions are a few symptoms of hypoglycaemia. Mild local itching at the injection site due to allergy atrophy of the local fat tissue leading to depressed areas can occur. Changing the site of injection is required. Mild weight gain is possible.
- What are the different types of insulin? They are the short acting regular insulin, intermediate acting , long acting with slow onset of action, rapid acting insulin analogs with more rapid onset and shorter duration of action. Mixtures of insulin are also used.
- What are the other preparations? Inhaled insulin is a premeal powered form of insulin administered by inhalation. Named as Exubera, it requires serial pulmonary function tests and is less effective then the injection.
- What are the myths and facts about insulin? When in type 2 diabetics the HbA1C is slowly rising inspite of your best efforts insulin is necessary. Insulin administration at this stage does not mean that you are a failure. Many people think that diabetes is a sugar problem. In fact it is an insulin problem.In fact insulin is the best way to reduce your blood glucose. Insulin does not cause complications or death. Insulin prevents complications due to diabetes. Insulin is not addictive and most of them are not very expensive. People think that insulin will change their life. In fact in many people insulin treatment changes their life for the better.
Many people feel that insulin administration have changed their life for the better. They have more energy, more flexibility in their schedule and feel more positive about themselves. After starting insulin many people wonder why they waited so long to feel better.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.