10/22/2024
Diabetes is a chronic metabolic disorder that impacts the body's method of handling blood sugar, or glucose. Glucose is a critical energy source for cells. Management of diabetes is founded on insulin: a hormone produced by the pancreas that regulates blood sugar levels. Insulin enables cells to absorb glucose from the blood to be used as energy or to be stored. The body may not produce enough insulin, or it may resist insulin’s effects.
To understand better the management of diabetes, let's know more about the role of insulin, how it acts within the body and the different types of insulin therapies that can effectively regulate the level of glucose in the bloodstream.
The Role of Insulin within the Body
Insulin is necessary for the body's function in either utilizing or storing glucose acquired from food. When one eats, the carbohydrates in the food are metabolized into glucose and will feed into the bloodstream. As a result, insulin is secreted by the pancreas and glucose can be absorbed into the cells in the body. The glucose can then be utilized within the cells for energy or be stored for later use.
In healthy individuals, this process runs smoothly, preventing blood sugar fluctuations. However, diabetes impairs this regulating mechanism in the body. This impairment can be of different types depending on the type of diabetes.
In Type 1 diabetes, the immune system destroys the insulin-producing cells in the pancreas, resulting in little to no insulin production. As a result, individuals must rely on insulin injections to survive. Individuals with Type 1 diabetes are dependent on injecting themselves with insulin to survive.
Type 2 Diabetes: Either does not produce enough insulin or becomes resistant to insulin. Some can control their condition with diet or lifestyle measures, oral medications, or injections of insulin as the disease worsens.
Why One Needs Insulin to Control Diabetes?
For the patient with diabetes, insulin therapy is typically required to keep blood glucose levels within acceptable boundaries. If blood glucose is chronically above the normal range, serious damage may result from cardiovascular disease to the kidneys, nerves, and eyes. Patients who inject insulin or use an insulin pump can better manage their blood sugar levels, though individual results may vary based on their overall health and diabetes management plan.
Types of Insulin Therapy
There are several forms of insulin available, all of which replicate the body's naturally acting insulin. These various types of insulin differ in terms of onset, or when they begin to work, and peak as well as duration. Their onset of action, peak as well as the time that they last vary. These forms of insulin each meet different individual needs, such as lifestyle, diet, and blood sugar patterns, among others.
Understanding the goals of insulin therapy is important when choosing the right type of insulin.
- Basal Insulin: This delivers a steady level of insulin throughout the day and night and helps control blood sugars between meals and at night.
- Bolus Insulin: These are taken at meal times to counteract the rise in blood sugar after eating. The intention behind this type of insulin is to act quickly and effectively so that spikes in blood sugars after meals are prevented.
Types of Insulin Chart
| Type of Insulin | Onset | Peak | Duration | Examples | When to Use |
| Rapid-Acting Insulin | 15-30 minutes | 1-2 hours | 3-4 hours | Lispro (Humalog), Aspart (NovoLog), Glulisine (Apidra) | Taken before meals to manage blood sugar spikes after eating. |
| Regular (Short-Acting) Insulin | 30-60 minutes | 2-3 hours | 5-7 hours | Humulin R, Novolin R | Taken before meals or for sliding scale insulin therapy. |
| Intermediate-Acting Insulin | 1-2 hours | 6-12 hours | 18-24 hours | NPH insulin (Humulin N, Novolin N) | Used twice daily for basal insulin coverage between meals and overnight. |
| Long-Acting Insulin | 2-4 hours | No distinct peak | 24-36 hours | Glargine (Lantus, Basaglar), Detemir (Levemir) | Taken once daily for continuous basal insulin coverage throughout the day and night. |
| Premixed Insulin | Varies (based on mixture) | Varies (based on mixture) | Varies (based on mixture) | 70/30, 50/50 | Taken twice daily to provide a mix of basal (long-acting) and bolus (short-acting) insulin, offering both meal and basal coverage. |
Factors to Consider While Choosing an Insulin Type
The kind of insulin that would suit you best would depend on many factors, such as
- Daily Routine: The time you eat, sleep, and have physical activity can also determine the amount of insulin you will require and how often.
- Monitoring blood sugar level: Tracking your blood sugar levels helps you identify the ideal times to inject insulin, ensuring better glucose control.
- Lifestyle and Preferences: Some individuals may need fewer injections throughout the day, while others may benefit from more meal flexibility. Either one could impact the type of insulin that they would need.
- Health Status: Any other health condition, such as kidney or liver disease, will impact how the body can absorb the body fluids or metabolize the insulin. That could affect what type of insulin regimen is used.
Your healthcare provider will work with you to determine which course of insulin therapy best serves your needs.
Most patients suffering from diabetes use insulin injections, either with the use of an insulin pen, a syringe, or an insulin pump. These methods administer insulin by subcutaneous injection. This means that injections penetrate the layer of fat beneath the skin, and they can be administered in the abdominal area, thighs, or upper arms.
Some General Guidelines for Safe Insulin Injection
- Rotate your injection sites regularly: To avoid lipodystrophy, like lumps or depression at the injection site, interchange the sites of injection. This also leads to the consistent infusion of insulin into the body.
- Proper Technique: Always use clean needles and keep on changing them with proper technique as advised by your doctor. This would help lessen pain while effectively delivering the insulin into the body.
- Insulin Storage: Correct storage of the insulin is necessary to maintain it as potent. Store unopened insulin in a refrigerator and opened insulin needs to be kept at room temperature for a specified duration. All this needs to be done as indicated on the label along with the product.
Managing Blood Sugar Levels with Insulin
Taking insulin as prescribed is only half the diabetes management job. Blood sugar monitoring, diet, exercise, and other drugs when needed are also important to keep diabetes under control. Only when the comprehensive management plan for diabetes accompanies a regimen of insulin therapy do the two work in harmony together. To get the best possible results you should become closely involved with your health-care providers.
Conclusion
Insulin is a lifesaving hormone for people with diabetes, and understanding how different types work empowers individuals to better manage their condition. Be it fast-acting insulin for rapid control of blood sugar peaks or long-acting insulin for steady control, the appropriate insulin regimen depends on your lifestyle and health goals. To find the right balance in insulin therapy, work closely with your healthcare provider to gain full charge of your diabetes management and treatment.