In a short and simple sentence, Insulin is a hormone that helps the body to control blood sugar. It is a hormone produced in the pancreas by certain cells called beta cells. Insulin helps in preventing blood sugar levels from becoming too high (hyperglycemia) or too low (hypoglycemia).
Its Medical Use
Insulin is used to treat a variety of illnesses. Some of its medical use are:
1. Treating diabetes and its complications:
The acute complications of diabetes result in life-threatening illnesses such as hyperosmolar hyperglycemic states and diabetic Ketoacidosis.
Extra: Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes in which the blood sugar level is high for a lengthy period of time, thus resulting in extreme thirst (i.e., severe dehydration) and confusion.
Diabetic ketoacidosis (DKA) happens when the body begins to break down fat at a pace that is much too quickly. The liver then converts the fat into a fuel that allows the blood to become acidic, called ketones. This disorder happens when the body does not have enough insulin.
2. Treating high blood potassium levels (hyperkalemia):
Hyperkalemia is when the potassium level in the blood is too high. Insulin is used alongside glucose to treat hyperkalemia.
Hint: Potassium has a natural range of between 3.6 and 5.2 millimoles per liter (mmol/L) of blood. A level of potassium greater than 5.5 mmol/L is critically high, and it can be life-threatening to have a level of potassium above 6 mmol/L.
3. Psychiatric treatment:
This treatment is called Insulin shock therapy in which patients were regularly injected with high doses of insulin to cause daily comas over a span of several weeks.
P.S.: This was introduced in 1927 but stopped in the 1960s and replaced with neuroleptic drugs.
Insulin and Its Types
People with diabetes will use various forms of insulin to have the desired effect on their blood sugar levels. This is due to reasons that what body system A needs is different from what body system B requires.
1. Rapid-acting insulins:
Around 15 minutes after you inject it into the tissue just under the surface, this insulin begins to function. It peaks in about an hour but continues to operate for two to four hours. Examples of rapid-acting insulins are Apidra, Novolog, and Humalog.
Extra: It’s usually taken with long-acting insulin before a meal.
2. Short-acting insulins:
Around 30 minutes after you inject it, this insulin begins working. It peaks in around two to three hours, but for three to six hours it operates continuously. Examples of short-acting insulins are Novolin R, Humulin R, and Velosulin.
Extra: It is usually given with long-acting insulin before a meal.
3. Intermediate-acting insulins:
Around two to four hours after you inject it, this insulin begins to function. It peaks in around four to 12 hours, but for 12-18 hours, it keeps running. Examples of intermediate-acting insulins are Humulin N and Novolin N
Extra: Usually, it is taken twice a day along with a form of insulin that is fast or short-acting.
4. Long-acting insulins:
Several hours (6 to 10 hours) after you inject it, this insulin starts working. It continues to function for around 24 hours. Examples of long-acting insulins are Lantus, Levemir, Basaglar and Tresiba.
Extra: It can be used with insulin that is rapid-acting or short-acting.
5. Premixed insulins:
They are the preferred option for certain people.
Click on this link for more info on Insulins and for a better list of various Insulin types.
Dosage and Method of Use
Dosage cannot be determined without the guidance of a doctor after carrying out the required test(s). It is important to note that:
- A meal should be eaten within 30 minutes of daily insulin administration.
- For each patient, the dosage is individualized.
- Insulin sliding scales (insulin doses based on glucose level) can be used to treat hospitalized patients who are critically ill.
- Some patients may develop insulin resistance and require the use of increased doses.
Insulin can be used in different ways such as:
- Insulin is normally administered to the abdominal wall, leg, buttocks (gluteal region), or upper arm by subcutaneous injection. Within the same area, injection sites should be rotated.
- Some insulin (e.g., short-acting or regular insulin) can also be supplied through the vein.
Doctors help determine which type of insulin and which method of delivery is better for a patient’s medical condition and lifestyles, such as an injection pen, a syringe, or a pump (a device that can deliver short-acting or rapid-acting insulin via a small catheter positioned just below the skin 24 hours a day).
Side Effects of Insulin
The most common side effect that can occur during insulin therapy is hypoglycemia. Symptoms of hypoglycemia are:
- Consciousness deprivation
- Blurred vision
- Palpitations in the heart
- Cold temperature, etc.
Other side effects are;
- Serious allergic reactions that are life-threatening, including anaphylaxis, can occur.
- Hypokalemia: Since insulin stimulates the transfer of potassium from the blood into cells, hypokalemia (low blood potassium) may occur. The risk of hypokalemia may be increased by combining insulin with potassium-lowering drugs.
- Weight gain
These side effects could happen but with the aid of a doctor, they can be managed. Diabetic patients need insulin therapy and can not afford to take the risk of undergoing treatment due to fear of these side effects. This is because the result of non-treatment is more deadly or fatal in the long run. Once treatment has commenced, regular follow-ups with the doctor can help checkmate side effects.
From the listed types of insulin, it is obvious self-medication is risky. A patient who needs rapid-acting insulin should not go for the long-acting insulin because it could be dangerous and damages may have been done before the insulin begins to kick in. thus, see a doctor for the right dose and use.
The fear of the side effects can not be compared with the result of non-treatment. Non-treatment results in life-threatening conditions. The doctor can be of guidance to help avoid or manage the side effects from the intake of insulin.
It is also vital to note that hepatic (liver) deficiency and renal (kidney) dysfunction may lower the requirement for insulin.
Finally, do not overdose on insulin. Follow doctor’s prescription(s) to avoid serious side effects. Remember, say no to drug abuse!!!