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Insulin for Diabetes - A detailed guide

The A-Z of insulin for diabetes, from how one should use it to understanding at which stage one needs it.

Insulin is a hormone produced by the pancreas in our body and is essential for our body organs to use glucose (sugar)in our blood as an energy source. In other words, insulin is the key that opens the door for glucose to enter in to the body organs. In diabetes, there is either total lack of insulin secretion as in Type 1 Diabetes, or Insulin produced might be too less or unable to act (Insulin Resistance) as in Type 2 Diabetes.Dr Manjunath Malige, Consultant Endocrinologist at Fortis Hospital, Bannerghatta Road, Bangalore, helps us in understanding the A-Z of insulin for diabetes, from how one should use it to understanding at which stage one needs it.

In our body, this is how insulin helps in regulating blood sugar levels.

Following food consumption, blood sugar level rises and this leads to Insulin secretion by the pancreas. Insulin will help body organs take up sugar and thereby, reduces the blood sugar levels. When the sugar level is normal or low, body stops Insulin generation so that the glucose level does not decrease. When body does not produce enough insulin then insulin injections may be needed.

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The four major types of insulin available in the market are:

There are various types of insulins as follows:

  1. Rapid or Short-acting Insulin: Once injected, this insulin starts acting within few minutes and brings down the blood sugar level rapidly. It remains in the body for about 4 hours and suitable to be used just before food as meal time insulin.
  2. Intermediate-acting Insulin: Once injected this insulin starts acting slowly by about 1 2 hours and will help control the blood sugar level for about 12 hours. This insulin is usually used once or twice daily either before breakfast or before evening dinner. Some intermediate insulins have a mixture or rapid acting and intermediate acting insulin in varying proportions.
  3. Long-acting Insulin: These insulins start acting rather slowly over a period of 2 3 hours and help control the blood sugars level for 24 36 hours and hence these insulins are used once daily either in the morning or in the evening.

Major characteristics of insulin

Insulin is a hormone produced in the body in response to high blood sugar level. When given as an injection for patients with Diabetes it does exactly the same job. The dosage and the choice of type of insulin is crucial in controlling the blood sugar level. Excess insulin can lead to low blood sugars (hypoglycemia) which will need urgent treatment to increase the blood sugar level. Insufficient and inappropriate type of insulin can lead to poor control of Diabetes and increases the risk of Diabetes complications. Sometimes people put on weight due to the use of insulin, so it's not a suitable treatment for everyone.

Understand the basics when planning to undertake insulin therapy

Insulin injections should be initiated by a Specialist (Diabetologist) with specific expertise in initiating and monitoring insulin therapy. Wrong insulin type and wrong dose of insulin can lead to complications. Type 1 Diabetes patients will need insulin right from the time of diagnosis, whilst type 2 Diabetes patient may require insulin a few years after the initial diagnosis, when tablets alone fail to control the blood sugar level. Insulin should always be taken before food with the right injection technique. Insulin injection sites should be rotated regularly so that lumps of fat do not develop under the skin. Read more about 10 insulin myths busted!

The right storage of insulin

Insulin injections should be stored in the door compartment of the refrigerator and not in the freezer compartment. Once taken out of the refrigerator, insulin can be stored at room temperature away from direct sunlight. Please read instructions leaflet that comes with your insulin injection. When travelling via air, Insulin ought to be stored in the hand baggage and not check in luggage. When travelling to places with high temperatures, insulin should be carried and stored in insulin cool packs.

The right time to take insulin

Insulin should be taken before meal contingent upon the kind of insulin used. Rapid-acting insulin should be taken just before the meal. Short-acting insulin should be taken 20 30 minutes before the meal. Intermediate and long-acting insulins should be taken before a meal at the same time every day. Patients who utilise Insulin Pump to convey insulin can take them at different conditions depending upon the blood glucose levels. Patients using Insulin Pump to convey insulin can take insulin at different conditions depending upon the glucose levels. Read here No more painful insulin injections. Insulin pills could make diabetes treatment painless

Do diabetics always need insulin? And at what stage of diabetes should one take insulin?

Not all Diabetic patients need insulin. Type 1 diabetic patients always need insulin. Type 2 diabetic patients may not require insulin for first few years as glucose level can be controlled by tablets. Pregnant diabetic patients usually will need insulin. Insulin may be needed temporarily in patients if undergoing a procedure or operation or during stressful periods. Diabetic patients with kidney failure will need insulin.

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