Insulin is a hormone produced by the beta cells in the pancreas. With each meal, these beta cells release insulin to aid the body in storing or utilizing the blood glucose it receives from the food, into energy.
The main function of insulin is to maintain the normal level of glucose in the bloodstream
Diabetes is a serious metabolic disorder which is produced due to the impact of insulin. Diabetes disease can considerably affects the quality of life and can reduce life expectancy.
There are different types of diabetes and in different types of diabetes either there is reduced insulin production or the body cells fail to react to insulin (known as insulin resistance). This results in increased levels of blood sugar.
- In type 1 diabetes, as the beta cells are destroyed the pancreas fails to make insulin hence, insulin shots are required to utilize the glucose from meals thereby, controlling the blood sugar levels. In this type of diabetes, permanent insulin shots shall be required by the patient.
- In type 2 diabetes, beta cells in the pancreas produce sufficient amounts of insulin but the body fails to respond to the insulin thus, causing elevated blood sugar levels. In type 2 diabetes and in gestational diabetes, if medications fail to help the body in utilizing glucose for energy then, insulin shots are required.
To control the elevated levels of blood sugar, the patient may require different types or doses of insulin. Insulin therapy plays an important role in the management of diabetes and it can even prevent diabetes complications by keeping the blood sugar levels within control.
There are three main features which differ in different types of insulin. The three features are:
- Onset of action – It is the length of time required for the insulin to act after the administration of the injection. It is the time prior to insulin reaching the bloodstream and reducing blood glucose.
- Peak-time – It is the time when the insulin acts the maximum in regards to reducing blood sugar.
- Duration of action – It is the time mentioning the duration of action of insulin in lowering blood glucose.
Based on how quickly the insulin acts, when they peak and on the duration that they last; insulin is classified into different types.
Some of the types of insulin are:-
- Rapid-acting insulin – Action of this type of insulin commences in around 15 minutes post injection. It peaks in around 1 hour and the action continues for approximately 2 to 4 hours. Rapid acting insulin is usually given immediately before the meal or in some cases can be given after the meal. It is generally given in combination with long-acting insulin.
Examples: Insulin glulisine (Apidra), insulin lispro (Humalog), and insulin aspart (NovoLog).
- Regular or Short-acting insulin – This type of insulin reaches the bloodstream in approximately 30 minutes post injection. It peaks around 2 to 3 hours post injection and the action continues for about 3 to 6 hours. Regular acting insulin should be injected 30 to 45 minutes before meals else, it can be taken before a meal.
Examples: Humulin R, Novolin R.
- Intermediate-acting insulin – After injection, this type of insulin reaches the bloodstream in around 2 to 4 hours. It peaks in about 4 to 12 hours and its action continues for around 12 to 18 hours.
Examples: NPH (Humulin N, Novolin N).
- Long-acting insulin – Several hours after the injection, long-acting insulin reaches the bloodstream. It tends to reduce the glucose level evenly over a 24-hour period. It is generally taken in the morning and is used with short-acting or rapid-acting insulin.
Examples: Insulin detemir (Levemir) and insulin glargine (Lantus).
- Pre-mixed Insulin – Onset of action takes place within 30 minutes. It reaches the peak within 2-4 hours and it is effective for 22-24 hours. Pre-mixed insulin is of great help in people having trouble drawing up insulin out of two different bottles. This type of insulin mixes short-acting and intermediate acting insulin and is generally administered two times a day. It is indicated in people with poor eyesight or dexterity. If the insulin mix that is recommended by your physician, fails to be available as a pre-mix then, you shall have to do the mixing yourself.
Examples: Humalog® Mix 75/25, Humalog® Mix 50/50, Humulin® Mix 70/30, Novolog® Mix 70/30, Novolin® Mix 70/30.
- Inhaled insulin – Inhaled insulin commences to work within 12 to 15 minutes. It peaks in around 30 minutes, and is out of the system in 180 minutes.
Examples: Technosphere insulin-inhalation system (Afrezza).
Insulin is accessible in varying strengths. Insulin strength is chiefly dependent on the dosage required by the patient. All types of insulin are available in a form which is dissolved or suspended in liquids which requires to be injected.
Mode of Administration
Insulin cannot be consumed as a pill as the pill would be broken down during digestion. Hence, for the insulin to get into our bloodstream, it must be injected into the fat under the skin. For the fastest delivery, insulin can be injected into the abdomen, for little more slowly into the upper arm and for the slowest delivery into the thigh or buttocks. The needle site for each shot should vary to avoid generating fatty deposits or hard lumps. The number of injections and the type of insulin required shall differ from patient to patient.
There are several methods by which insulin can be delivered. Insulin can be delivered via a needle & syringe; a pre-filled pen; a cartridge system or an insulin pump.
Some of the side effects of insulin administration are as follows:
- Hypoglycaemia (Low blood sugar).
- Weight gain.
- Scars on lumps on site of several injections.
- Allergic reactions.
- Low potassium levels.
Based on the blood sugar levels, the physician may advice combining more than one type of insulin. To decide the type and quantity of insulin required, several factors shall be considered by the physician. Factors such as blood sugar levels, type of diabetes, fluctuation of blood sugar levels and lifestyle of the patient may be considered.
For effective results, insulin should be stored properly. Some of the steps for proper storage of insulin are mentioned below:
- Store the bottle in use at room temperature for 30 days.
- Keep it far from direct sunlight and from extreme temperatures.
- Extra bottles of insulin have to be kept in the refrigerator.
- Do not store the insulin bottle in the freezer. Avoid freezing of insulin.