Insulin is a natural hormone produced by the beta cells of the pancreas. This hormone plays a very important role in the metabolism of sugar (glucose) in the body and helps regulate blood sugar levels. In addition to its role in sugar metabolism, insulin is also effective in regulating the storage of fat and protein.
Function of insulin:
Reducing blood sugar levels:
Insulin causes the body’s cells (such as muscle and fat cells) to absorb glucose from the blood and use it as a source of energy.
Storing glucose as glycogen:
In the liver, insulin converts excess glucose into glycogen and stores it for later use.
Inhibiting glucose production in the liver:
Insulin reduces the production of glucose by the liver.
Types of insulin medication:
In patients with diabetes whose body does not produce enough insulin (such as type 1 diabetes) or is resistant to insulin (such as type 2 diabetes), insulin is prescribed in the form of medication. This insulin is divided into several categories:
Rapid-acting insulin:
It starts its effect within 15 minutes and lasts for about 2 to 4 hours.
Example: Lispro, Aspart.
Short-acting insulin:
It starts its effect after about 30 minutes and lasts for 3 to 6 hours.
Example: Regular insulin.
Intermediate-acting insulin:
It usually takes 2 to 4 hours to take effect and lasts for up to 12-18 hours.
Example: NPH insulin.
Long-acting insulin:
It has a continuous and long-lasting effect (up to 24 hours) and is usually injected once a day.
Example: Glargine, Detemir.
Premixed insulin:
Contains a combination of rapid-acting and intermediate-acting insulin and is used to control blood sugar at specific times.
Uses:
Type 1 diabetes:
The patient is insulin-dependent because the body does not produce any insulin.
Type 2 diabetes:
In advanced stages, when oral medications are not enough or insulin resistance is severe.
Gestational diabetes:
If blood sugar levels are not controlled by diet.
Method of administration:
Insulin is usually administered by subcutaneous injection (under the skin). There are also devices such as insulin pumps and insulin pens for ease of use.
Possible side effects:
Hypoglycemia (low blood sugar):
The most common side effect of insulin, which may cause symptoms such as sweating, tremors, confusion, and weakness.
Sensitivity or allergic reaction:
Rare but may occur at the injection site.
Weight gain:
Due to increased storage of glucose as fat.
1. Key points in insulin use
To achieve better blood sugar control, it is essential to observe the following:
Insulin injection timing:
Depending on the type of insulin, the timing of injection must be carefully observed. For example, rapid-acting insulin is usually injected before a meal.
Appropriate dosage:
The doctor determines the insulin dosage based on the patient’s individual needs and blood sugar levels. Using more or less than the prescribed amount can cause serious complications.
Injection site:
Insulin should be injected in different parts of the body (such as the abdomen, arm, thigh, or buttocks) to prevent lipoatrophy or lipohypertrophy (changes in fatty tissue).
Insulin storage:
Insulin should be stored at refrigerator temperature (2-8°C), but should not be frozen. Once opened, it can usually be used at room temperature (below 30°C) for a limited time.
2. Advanced Technologies in Insulin Management
Technological advances have led to new methods of administering insulin:
Insulin pump:
A device that continuously injects insulin throughout the day and can be adjusted depending on the patient’s needs. This method is very useful for patients with type 1 diabetes and some type 2 diabetes who need precise control.
Insulin pen:
These devices are more convenient and accurate than traditional syringes and help patients inject the right dose of insulin easily.
Continuous glucose monitoring (CGM) systems:
These devices can measure blood sugar levels in real time and can be integrated with some insulin pumps.
Smart insulin:
Is under research and may be activated automatically based on the patient’s blood sugar levels in the future.
3. Insulin and Diet
Diet and insulin should be coordinated:
Carbohydrate counting:
The patient should know the amount of carbohydrates in their meals to adjust the appropriate insulin dose.
Avoiding high-sugar and high-fat foods:
Foods that quickly raise blood sugar levels should be limited.
Regular meals:
In patients who use insulin, missing meals may cause a severe drop in blood sugar.
4. Insulin and physical activity
The effect of exercise on insulin:
Exercise can reduce the need for insulin because it increases the sensitivity of cells to insulin. However, it is necessary for the patient to check their blood sugar levels before exercise to prevent hypoglycemia.
5. Managing Side Effects
Although insulin is generally safe, it can cause side effects:
Hypoglycemia (severe low blood sugar):
If you experience symptoms such as weakness, sweating, palpitations, or dizziness, you should immediately take glucose (e.g., fruit juice or glucose tablets).
Injection site reactions:
Varying the injection site and using proper injection technique can help reduce these problems.
Weight gain:
Usually can be controlled with proper diet and exercise.
6. Insulin during pregnancy
Gestational diabetes, or pre-gestational diabetes, requires careful management:
Insulin is a safe drug for pregnancy and is usually used as the first line of treatment.
Careful blood sugar control is important to prevent complications in both the mother and the fetus.
7. Future developments in insulin
Research into diabetes treatment continues and includes the following:
Inhaled insulin:
Instead of injections, insulin is delivered to the body through an inhaler.
Pancreatic beta cell transplantation:
A potential solution for treating type 1 diabetes.
Longer-acting insulin:
Development of insulins that may last for a week or more.
Insulin is a medication used to manage blood sugar levels in patients whose bodies cannot produce or use insulin properly. It is used to treat type 1 diabetes, type 2 diabetes, and certain other conditions.
Main uses of insulin:
1. Type 1 diabetes
Type 1 diabetes patients do not produce normal insulin due to destruction of the beta cells in the pancreas.
For these patients, insulin is a vital treatment and must be used regularly to regulate blood sugar.
2. Type 2 diabetes
In the advanced stages of type 2 diabetes, when oral medications and lifestyle changes are not enough, insulin is used to lower blood sugar.
Sometimes these patients also use insulin in addition to oral medications.
3. Gestational Diabetes
Insulin is prescribed for pregnant women whose blood sugar is not controlled by diet or physical activity.
Insulin is safe for the fetus and prevents complications caused by high blood sugar during pregnancy.
4. Diabetes related to certain diseases or conditions
Pancreatogenic diabetes (diabetes secondary to pancreatic diseases): In diseases such as chronic pancreatitis or after removal of the pancreas.
Drug-induced diabetes: Such as corticosteroids, which cause blood sugar levels to rise.
5. Control of acute hyperglycemia
Insulin is prescribed in cases such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic syndrome (HHS), where blood sugar levels are very high.
6. Temporary treatment of hyperglycemia
Insulin may be used temporarily in patients whose blood sugar levels are high due to surgery, stress, or infection.
7. Pancreas or kidney transplant
Patients who are preparing for or after a transplant may need insulin to control blood sugar.
Insulin treatment goals:
Maintain blood sugar levels in or near normal range (usually 70-130 mg/dL fasting and less than 180 mg/dL after meals).
Reduce the risk of complications of diabetes, such as damage to the kidneys (diabetic nephropathy), eyes (diabetic retinopathy), nerves (diabetic neuropathy), and cardiovascular disease.
Improve quality of life and prevent hyperglycemia or hypoglycemia.
Here are more details about the uses and benefits of insulin, as well as its role in diabetes management and how to use it:
Benefits of using insulin
Precise blood sugar control:
Insulin can precisely regulate blood sugar levels and prevent severe fluctuations (hyperglycemia and hypoglycemia).
Preventing long-term complications of diabetes:
By controlling blood sugar, insulin helps prevent problems such as damage to the eyes (blindness), kidneys (kidney failure), blood vessels (heart attack or stroke), and nerves.
Managing gestational diabetes:
Insulin is the best and safest blood sugar-regulating medication for pregnant women because it does not harm the fetus.
Use in emergencies:
In conditions such as diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome, insulin plays a vital role in rapidly lowering blood sugar.
Flexibility in diabetes management:
With different types of insulin (rapid-acting, intermediate-acting, and long-acting), treatment plans can be tailored to fit your lifestyle.
How to use insulin
Subcutaneous injection:
The most common way to take insulin is by injection subcutaneously (under the skin). This is done using a syringe, insulin pen, or insulin pump.
Insulin pump:
A small device that continuously injects insulin into the body, keeping blood sugar levels stable throughout the day.
Intravenous (IV) injection:
In emergencies such as diabetic ketoacidosis, insulin is injected through a vein to work quickly.
Essentials when using insulin
Strict timing:
Depending on the type of insulin, the timing of the injection must be carefully followed. For example, rapid-acting insulin should be injected 15-30 minutes before a meal.
Continuous blood sugar monitoring:
Patients should check their blood sugar levels with glucometers or continuous glucose monitoring (CGM) systems to adjust insulin doses appropriately.
Diet compliance:
The type and amount of food consumed directly affects insulin requirements. Patients should include carbohydrate counting in their daily diet.
Preventing low blood sugar (hypoglycemia):
Patients should recognize the symptoms of hypoglycemia (such as weakness, shakiness, headache, or dizziness) and, if they occur, immediately consume simple sugars such as fruit juice or glucose tablets.
Limitations and possible side effects of insulin
Hypoglycemia:
A severe drop in blood sugar is the most common side effect. It may be caused by taking a high dose of insulin, skipping meals, or exercising too much.
Injection site reactions:
Redness, swelling, or changes in fatty tissue (lipohypertrophy or lipoatrophy) may occur at the injection site.
Weight gain:
Because of increased storage of glucose as fat, weight gain may occur in some patients.
Need for education:
Patients using insulin require specialized education on how to inject, manage hypoglycemia, and count carbohydrates.
New developments in insulin
Inhaled insulin:
This type of insulin is taken through an inhaler and does not require injections. It is designed to control blood sugar after meals.
Longer-acting insulin:
Insulins that are injected once a week and provide long-term blood sugar control are under development.
Artificial pancreas:
A device that uses an insulin pump and a blood sugar sensor to automatically adjust insulin levels.
Who needs insulin?
All patients with type 1 diabetes.
Patients with type 2 diabetes who cannot control their blood sugar with oral medications or lifestyle changes.
Pregnant women with diabetes.
People who have high blood sugar due to other diseases or taking medications such as corticosteroids.
Patients in emergency conditions such as diabetic ketoacidosis.
Using insulin requires care and attention to certain points in order to best control blood sugar levels and prevent possible complications. The following are the steps, methods, and important points for using insulin:
1. Preparing insulin
Inspecting insulin:
Before injecting, you should inspect the insulin. If you are using clear insulin (such as rapid-acting or long-acting insulin), it should not contain particles or discoloration. If the insulin is cloudy (such as NPH insulin), you should shake it gently to make it uniform.
Temperature:
Insulin is best injected at room temperature, as cold insulin injections may be painful. However, it should be refrigerated during storage.
2. Insulin injection tools
There are different methods for injecting insulin, including:
a) Insulin syringe:
Insulin syringes come in different sizes and must be carefully filled to the correct dose.
Fill the syringe with insulin and make sure there is no excess air inside.
B) Insulin Pen:
This device makes insulin use easier and more accurate. Pens already contain insulin and the patient only needs to adjust the dose and inject.
Before use, test the pen to make sure that insulin comes out of it.
C) Insulin Pump:
It is an automatic device that continuously injects insulin into the body. This method is mostly used for patients with type 1 diabetes or those who need close control.
3. How to inject insulin
Choosing an injection site:
Insulin should be injected into the subcutaneous tissue. Suitable points are:
Abdomen (2 finger widths from the navel)
Upper arm
Front thigh
Upper buttock or waist
Change the injection site each time to prevent lipohypertrophy (fat accumulation at the injection site).
Disinfecting the injection site:
Before injecting, disinfect the site with a cotton swab dipped in alcohol and wait for it to dry.
Injection:
Insert the needle into the skin at a 90-degree angle (or 45 degrees in thin people).
Inject the insulin slowly.
Keep the needle in the skin for 5-10 seconds to make sure all the insulin has been injected.
Removing the needle:
Withdraw the needle and replace the cap. If bleeding occurs, gently press the site (do not massage).
4. Timing of insulin injection
The timing of injection depends on the type of insulin:
Rapid-acting insulin:
Injected 15-30 minutes before a meal.
Short-acting insulin:
Injected 30 minutes before a meal.
Intermediate-acting insulin:
Usually once or twice a day, depending on your doctor’s advice.
Long-acting insulin:
Once a day, often at night, to control blood sugar throughout the day.
5. Essential precautions in using insulin
Continuous blood sugar monitoring:
Check your blood sugar levels with a glucometer or continuous glucose monitoring (CGM) system to adjust the appropriate insulin dose.
Diet coordination:
The foods you eat directly affect your insulin needs. Count the carbohydrates in your meals and adjust your insulin dose accordingly.
Exercise:
Exercise can reduce your insulin needs. Check your blood sugar before exercising and eat a snack if necessary.
Preventing hypoglycemia:
Always carry a quick-acting sugary snack (such as juice, chocolate, or glucose tablets) with you to take if your blood sugar drops.
6. Insulin storage
Unopened insulins should be stored in the refrigerator (2-8°C).
Once opened, insulin can be stored at room temperature (below 30°C), but should be used within 28 days.
Insulin should not be frozen or exposed to extreme heat.