- Insulin Therapy
What is insulin?
Insulin is a hormone that is produced by beta cells. These beta cells are highly specialized cells that reside in a gland in the abdomen, called the pancreas. The function of the insulin is reduce the glucose levels in the blood. When insulin levels are not enough, or when the body becomes resistant to insulin, the glucose levels rise. When the glucose levels rise beyond limits, this condition is called hyperglycaemia.
Insulin as a form of diabetes treatment
Insulin is, in some ways a very natural form of therapy for diabetes. For instance, in type 1 diabetes (some people call this “juvenile diabetes”), the patient’s pancreas has lost the ability to produce insulin. This case, insulin is the only possible treatment. A type 1 diabetic who does not take insulin can even die due to a catastrophic illness called diabetic ketoacidosis. However, not all diabetics require insulin. For instance, the common variety of diabetes in India, called type 2 diabetes, can be very well controlled with diet control, exercise and oral pills during the early stages. After many years of type 2 diabetes, however, pancreas begins to fail, and insulin therapy is needed.
Insulin has three distinct advantages as a treatment for diabetes,
- Insulin always, or rather nearly always, works in all cases of diabetes
- Insulin can be given to achieve rapid control of diabetes, as in diabetic patients undergoing surgery
- Insulin injection therapy is usually designed to mimic the body’s insulin production
What is the body’s insulin production pattern?
Normally, the pancreas releases insulin in a peculiar pattern, so that glucose control in the body is smooth. This pattern is called “Basal – Bolus” pattern. Quite simply put, the body basically requires a basal or minimum level of insulin throughout the day to maintain glucose levels. This is the basal insulin release. Every time we eat food, our body receives a fresh spurt of glucose requires a fresh spurt of insulin –this is called the bolus spurt of insulin. Thus, the insulin pattern in the body consists of a 24 hour basal, minimum insulin level. Basal level is superimposed by bolus waves of insulin each time that food is given.
It is important to understand this because all insulin injection try to mimic this pattern. Short acting injections try mimic the bolus, and long acting insulin mimic the basal insulin.
Situation where diabetes requires insulin treatment
- Type 1 diabetes
- Type 2 diabetic not responding to pills
- Diabetes undergoing surgery
- Diabetes complicating pregnancy
- Diabetics admitted to Intensive care unit (ICU)
- Unusual forms of diabetes
- Pancreatic damage – related diabetes
- Weight loss
- Other illnesses like infections
- For instance chronic pancreatic damage due to alcoholism.