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A Brief Overview of Insulin

Updated on July 5, 2017

What Is Insulin?

Insulin is a peptide hormone made by the beta cells in the pancreas. This chemical messenger enables the body to use glucose (obtained from carbohydrates in the food) for energy, or to store the sugar for future use.

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Insulin and Diabetes

Type 1 diabetes occurs when the immune system destroys beta cells that produce insulin. This leads to increased blood sugar levels in the body.

Insulin Resistance

In a person affected by type 2 diabetes, beta cells produce insulin but the body is not able to use it. This is insulin resistance. Over time the pancreas becomes unable to produce enough insulin to overcome resistance, leading to full-blown diabetes.

After a High Fat Meal, an Extra Dose of Insulin Regulates Blood Sugar Levels and Prevents Cardiovascular Disease

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POMC Neurons at the Hypothalamus are Linked to the Release of Insulin by the Pancreas

A research study co-chaired by Marc Claret, at the August Pi i Sunyer Biomedical Research Institute -- IDIBAPS, and Antonio Zorzano, at the Institute for Research in Biomedicine (IRB Barcelona), both members of the CIBERDEM network, reveals the connection between POMC neurons at the hypothalamus and the release of insulin by the pancreas.

Study Was Published in Cell Metabolism

It explains new molecular mechanisms involved in this connection. The researchers publish the study in Cell Metabolism and the first authors are Sara Ramírez and Alicia G. Gómez-Valadés, both at IDIBAPS.

It was surprising to discover that these neurons are involved not only in the control of the intake, which was already known, but also in the control of the amount of insulin secreted by the beta cells of the pancreas.

- Antonio Zorzano, Head of the Laboratory of Complex Metabolic Diseases and Mitochondria at IRB Barcelona

Insulin As Medicine

Insulin is used as a medicine to treat high blood sugar. It is used to treat diabetes and its complications like diabetic ketoacidosis and hyperosmolar hyperglycemic states.

Insulin is the elixir of life for me. I literally couldn't live without it.

- Christine Turner, the director of community engagement at JDRF (formerly the Juvenile Diabetes Research Foundation).

Insulin Injection Dose

"Improving the sugar and fat levels in the blood after eating is important for the long-term health of the heart and blood vessels. But calculating insulin injection dose based on carbohydrates alone is clearly too simplistic, as most people eat meals that include fat and protein too," said Dr Daniel West from Newcastle University.

After a High Fat Meal, an Extra Dose of Insulin Regulates Blood Sugar Levels and Prevents Cardiovascular Disease

“Our findings show that, after a high fat meal, an extra dose of insulin provides a very simple way of both regulating blood sugar levels for short term health and protecting against the long term risks of cardiovascular disease....

“We feel strongly that the advice given to people with type 1 diabetes needs to be updated to take this new information into account," said Dr Matthew Campbell from Leeds Beckett University.

Our findings show that, after a high fat meal, an extra dose of insulin provides a very simple way of both regulating blood sugar levels for short term health and protecting against the long term risks of cardiovascular disease.

— Dr Matthew Campbell, Leeds Beckett University.

Types of Insulin

Type
Onset
Rapid-acting
10 - 30 minutes
Short-acting
30 - 60 minutes
Intermediate-acting
90 - 240 minutes
Long-acting
50 - 240 minutes

Insulin Injection Is Used to Control Blood Sugar in People With Type 1 Diabetes

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Rapid-Acting Insulin

This insulin acts very quickly to minimize increase in blood sugar which follows food consumption. It is usually taken just before or during a meal.

Short-Acting Insulin

Short-acting insulin is a preparation of regular insulin with an onset period of around 20 minutes. It reaches peak of action in around a couple of hours. The duration of action is around six hours.

Intermediate-Acting Insulin

It is usually taken in conjunction with short-acting insulin. It begins to act within the first hour of injecting. Its peak activity lasts upto seven hours, after which the activity begins to tail off.

Intermediate-Acting Insulin Is Usually Taken in Conjunction with Short-Acting Insulin

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Long-Acting Insulin

Typically injected once a day, this insulin is available in animal and analogue forms. It takes long time to begin working; it can take upto four hours to get into your blood stream. Insulin degludec injection, one type of long-acting insulin, lasts upto 42 hours.

Insulin Administration

Inhalable Insulin

Afrezza is a powder form of insulin that is delivered into the body through an inhaler and absorbed through the lungs. This fast-acting insulin should be used at mealtimes.

It’s just as efficient as injecting it under the skin, and actually probably a little bit quicker.

— Dr. Leonard Zemel, an endocrinologist with Creekside Endocrine Associates

Insulin Side Effects

Low blood sugar is the most common side effect of insulin. Blurry vision, increased urinary albumin excretion rate, swelling, weight gain and gastrointestinal distress are other known side effects.

Insulin Price

When Frederick Banting discovered insulin in 1923, he refused to put his name on the patent. He felt it was not ethical for a physician to make money out of a discovery that would save lives of people.

Inventors' Intention

Banting’s co-inventors, James Collip and Charles Best, sold the insulin patent to University of Toronto for a $1. They also wanted everyone who needed their medicines to be able to afford it.

What Is Happening Today?

Today Banting and his wonderful colleagues would be uncomfortable in their graves: Their medication, which millions of diabetics worldwide rely on, has become the latest poster child for pharmaceutical price gouging.

Pharmaceutical Companies Are Making Money At the Cost Of Diabetics

On May 2 2017, the pharmaceutical giant Eli Lilly increased the prices of its insulin medicines, Humalog and Humulin, by 7.8 percent, according to newly obtained records from CNBC’s Meg Tirrell.

And Lilly is not the only company to do so: Sanofi and Novo Nordisk, the only two other companies that manufacture insulin in the US, have been increasing insulin prices recently too.

Life Of Poor Diabetics Is Becoming Harder Day By Day

Patients can now expect to pay upward of $400 per month for this medicine. Pharmaceutical companies use the “cost of innovation” argument to justify the price increases — but critics do not buy their reasoning. Diabetics who depend on the daily lifesaving drug are furious.

Class Action Suit Accusing Price Fixing

In January 2017, patients filed a class action lawsuit accusing the three companies of price fixing. The American Diabetes Association's board of directors had asked Congress to investigate insulin price increases.

USA Generates Around Half Of Pharma Industry's Insulin Revenue

While the USA represents only around 15 percent of the global insulin market, it generates almost 50 percent of the pharmaceutical industry’s insulin revenue. According to a recent study in JAMA Internal Medicine, in the 1990s Medicaid paid between $2.36 and $4.43 per unit of insulin; by 2014, those prices more than tripled, depending on the formulation. Authorities worldwide should take appropriate steps to ensure that insulin price does not become unaffordable.

Insulin Storage

Pure insulin should not look cloudy. It should not have any clumps, sediment or crystals. It should not have bad odor. You need to maintain its purity.

Insulin has specific storage requirements. Depending on the type of insulin you take, your insulin products come with specific instructions for storage. It is very important to follow them.

Insulin medications and meters should not be stored in extreme heat or extreme cold temperatures. Insulin is sensitive to sunlight and indoor light. Never store insulin medication on the window ledge.

Summary

  • Insulin is produced in the pancreas.
  • Condition wherein the immune system destroys beta cells that produce insulin is known as type 1 diabetes.
  • Insulin is used to treat hyperglycemia.
  • Onset time of rapid-acting insulin is 10 - 30 minutes.
  • Long-acting insulin is injected once daily.

Insulin is not a cure for diabetes; it is a treatment. It enables the diabetic to burn sufficient carbohydrates, so that proteins and fats may be added to the diet in sufficient quantities to provide energy for the economic burdens of life.

— Sir Frederick Grant Banting

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