Insulin
BY
DENTAL STUDENT
Mahmoud Kamal Mohammed Saeed
Group C
Introduction
Insulin acts as a key to promote the cellular uptake of
glucose.
Insulin is also an anabolic hormone, promoting fat deposition
and protein synthesis.
Without diabetes, the level of insulin secreted by the
pancreas should be proportional to the circulating blood
glucose level.
If insulin is absent or deficient, hyperglycemia is likely to
result, which can increase the risk of osmotic symptoms and
the risk of DKA.
A person with insulin treated type 2 diabetes is presumed to
have lost the ability to either produce enough endogenous
insulin to keep glucose levels controlled, or be too insulin
resistant for their own pancreas to secrete enough insulin to
control glucose.
If insulin needs to be administered as part of diabetes
management, the level will not always be proportional to the
blood glucose level. Insulin dose adjustment is likely to be
necessary depending on the blood glucose measurements.
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The types of insulin used to treat diabetes
All insulin comes to you in liquid form.
Rapid-acting
Rapid-acting insulin begins to effect blood glucose about 15
minutes after injection. While rapid-acting insulin may peak
in an hour, they continue to work after a few hours. Rapid-
acting insulin should be injected before a meal. Do not delay
eating a meal when using rapid-acting insulin.
Short-acting
Regular or short-acting insulin reaches your bloodstream
usually within 30 minutes after injection. It peaks in the 2-3
hour range and stays effective for 3-6 hours.
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Intermediate-acting
this type of insulin includes NPH (neutral protamine
hagedorn) that help control glucose for 10-12
hours. A protamine is a type of protein that slows the action
of insulin. NPH is partially named after Hans Christian
Hagedorn, who was instrumental in leading insulin research
beginning around 1923. He was the one who discovered that
adding protamine to insulin prolonged its effect.
Long-acting
Long-acting insulin enters the bloodstream 1-2 hours after
injection and may be effective for as long as 24-hours. An
advantage to long-acting insulin is avoidance of a pronounced
peak and more closely works like normal pancreatic basal
insulin secretion.
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Insulin Delivery
1. Syringe
2. Insulin Pen
3. Insulin Pump
4. Jet Injection
5. Insulin Injection Technique
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How to Store Your Insulin
Keeping your ‘current’ insulin (i.e., a few days or a week’s
supply) at room temperature can help alleviate injection
discomfort.
Insulin available in vials can usually be stored at room
temperature for about a month. Insulin in a pen should
be stored at room temperature once in use. Expiration
date of insulin pens can vary depending upon the type of
insulin. For disposable pens, the entire device is
discarded when empty or when expiration date is
reached.
Store extra insulin (2-3 week supply or more) in the
refrigerator.
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Do not expose insulin to excessive cold (e.g., in a freezer)
or heat (e.g., in direct sunlight).
How Do Insulin Pumps Work?
Insulin pumps are small, computerized devices that mimic
the way the human pancreas works by delivering small doses
of short acting insulin continuously (basal rate). The device
also is used to deliver variable amounts of insulin when a
meal is eaten (bolus). The basal insulin rates are usually set
up in your pump with your doctor, and you can have one or
multiple basal settings programmed in your pump, based on
your needs. You program the amount of insulin for your
mealtime bolus directly on the pump. Most pumps come with
built-in bolus calculators to help you figure out how much
insulin you need at mealtime based on your glucose levels and
the amount of carbohydrates you are eating.
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Types of Pumps
A variety of insulin pumps are available, and your
diabetes care team can help you choose the best pump
for you. In general, there are two types of pump
devices:
1. Traditional Insulin pumps have an insulin reservoir
(or container) and pumping mechanism, and attach to
the body with tubing and an infusion set. The pump
body contains buttons that allow you to program insulin
delivery for meals, specific types of basal rates, or
suspend the insulin infusion, if necessary.
2. Insulin patch pumps are worn directly on the body and
have a reservoir, pumping mechanism, and infusion set
inside a small case. Patch pumps are controlled
wirelessly by a separate device that allows programming
of insulin delivery for meals from the patch.
What Are the Parts of an Insulin Pump?
Traditional insulin pumps contain three main parts:
1. pump.
2. - tubing.
3. - infusion set
Insulin Treatment for Diabetes
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People with type 1 diabetes cannot make insulin because the
beta cells in their pancreas are damaged or destroyed.
Therefore, these people will need insulin injections to allow
their body to process glucose and avoid complications from
hyperglycemia.
People with type 2 diabetes do not respond well or are
resistant to insulin. They may need insulin shots to help them
better process sugar and to prevent long-term complications
from this disease. Persons with type 2 diabetes may first be
treated with oral medications, along with diet and exercise.
Since type 2 diabetes is a progressive condition, the longer
someone has it, the more likely they will require insulin to
maintain blood sugar levels
Reference:
https://www.mkuh.nhs.uk/treatment-and-management-of-diabetes/diabetes-
treatments/insulin/introduction-to-
insulin#:~:text=Introduction%20to%20insulin,the%20circulating%20blood%20glucose%
https://www.endocrineweb.com/conditions/type-1-diabetes/what-insulin
https://www.endocrineweb.com/conditions/diabetes/diagnosing-diabetes
https://www.endocrineweb.com/conditions/diabetes/treatment-diabetes
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Thank you
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