All About Insulin and Medications
The main concern for patients with diabetes is to be able to balance their blood glucose levels. To this end it is likely that their doctor will suggest a specific diet and exercise routine as well as insulin or medications depending on the type of diabetes you are suffering from. While insulin therapy is mainly used to treat type 1 diabetes, for type 2 diabetes there are a number of drugs available.
What is Insulin?
Insulin is a hormone secreted by cells of the pancreas, and is required to help these cells absorb glucose into the bloodstream to give us energy. In people with diabetes, this process is stunted, since, if you have type 1 diabetes, your body does not produce insulin at all, while in people with type 2 diabetes diabetes, they simply do not produce enough. The result is loss of energy, stunted growth and the inability of the body to repair itself.
What insulin treatment a diabetic will receive, however, will depend on many factors such as age, any other health problems, blood glucose levels, diet, diabetes symptoms, and what type you have. Furthermore, once you start taking insulin, there are other things that need be taken into account, like the amount of exercise you do, mealtimes and what types of foods you are consuming during the day. In most cases, a doctor may suggest a steady insulin dose throughout the day with increased dosage at meal times.
Types of insulin
Nowadays there are many forms of insulin available in the market for diabetics. Depending on your lifestyle, exercise routine, and diet plan, the doctor may prescribe any one or combination of the following:
- Regular insulin: Regular insulin generally takes effect 30 minutes after its been taken. It is effective for about 6-8 hours and reaches its peak at about 4 hours. It is usually taken before meals, especially if you are eating a high fat meal.
Intermediate acting insulin: This type of insulin starts working within 1 or 2 hours and its effect lasts for around 16 hours. There are other types of insulin in this category like lente, which act for almost 18 hours.
Long acting insulin: As the name suggests, this type of insulin is released slowly but remains active for around 24 hours. It is primarily useful in maintaining steady insulin secretions into the body to balance blood glucose levels throughout the day. When compared to intermediate insulin this kind show less risk of hypoglycemia or weight gain.
Fast acting insulin: If blood glucose levels shoot very high – as can happen after eating a meal rich in carbohydrates – you may need the insulin to take affect instantly. As its name suggests this type of insulin acts fast, but its effect lasts only for about 4 hours. It is generally only recommended for extreme circumstances, as it does not last as long and does not help to maintain balanced sugar levels. It is usually required to be taken 15 minutes before a meal and has been suggested to be good for children suffering from diabetes.
Methods of Administration
Insulin is normally taken with the help of injections. It cannot be taken orally because the digestive juices may destroy it. Depending on your particular case, you may be asked to take anywhere from 2 to 3 injections in a day using a combination of fast and slower acting insulin. This combination helps in simulating the normal insulin secretion of the pancreas that is low most of the time, with increased secretion during meal times.
However, injections are by far the only the way to administer insulin to the body. Today diabetics have several other options available to them, such as:
An insulin pump has become a beneficial tool, especially for those diabetes patients who: have a tendency towards dipping blood sugar levels during the night; have frequent work loads; or whose blood sugar level shows frequent highs and lows.
It is a small, simple electronic device that stores enough insulin for a few days, which is pumped into your body through a needle and a tube usually inserted in the abdomen area. You can control the dosages, giving yourself smaller doses at regular intervals during the day, and larger ones during meals. Because they provide added flexibility and mobility, many individuals have reported feeling they’ve regained control over life through the use of insulin pumps.
Insulin pens have a cartridge of insulin that is stored in a pen-like device with a short needle on the end of it. Many people find that pens are much easier to use that an injection and are more accurate and convenient. There are also disposable, pre-filled pens available that can be used and then discarded.
Points to remember with insulin therapy
Since there is no cure for diabetes, insulin therapy may become a crucial element of your treatment regime. Insulin treatment is also a way to avoid further complications diabetes such as heart and kidney disease. Of course, it is also important to note is some of the problems that may arise with insulin use. These may include:
- Hypoglycemia, or a dangerous drop in blood glucose levels
- Weight gain and the associated problems of high blood pressure and cholesterol
With insulin treatment, therefore, you should keep the following points in mind:
- Monitor your blood glucose levels regularly
- Align your meals and food intake with insulin therapy, and be sure not to skip meals - especially if you have already taken a high dose of insulin
- Keep fit and exercise moderately every day to steer off weight gain – but don’y overdo it as this could cause glucose levels to dip to dangerous levels
- Sleep well
- Develop a diet plan with the help of your doctor and stick to it
- Sulfonylurea: These medicines work by forcing the pancreas to produce insulin. However, for the drugs to be effective, your pancreas should be able to secrete at least a small amount of insulin on its own. The side effects of these drugs could consist of:
- Weight gain
- Skin rash
- Stomach upset
- Low blood sugar
- Nausea, vomiting, feeling dizzy
- Metformin can make you sick if you are drinking 2-3 alcoholic drinks or more in a week
- Diarrhea or other stomach problems
- Kidney problems may make the drug accumulate in the body
- Metallic taste
- Liver problems like nausea and vomiting
- Very low blood sugar
- Weight gain
- Risk of anemia
- Swelling of legs
Biguanides: Also known under the more common name of metformin these diabetes medications act by preventing the liver from producing too much sugar as well as lower insulin levels in the body. If you have are overweight, a common symptom of diabetes, this drug is often prescribed as it helps in weight control, and lowering of cholesterol level. Side effects may be:
Alpha glucosidase inhibitors: These drugs block the enzymes in your body that digest starches. In this way blood sugar levels rise very slowly and enough insulin is available to break down the glucose. Side effects may include: diarrhea, bloating, gas or other kinds of stomach problems.
Meglitinides: Meglitinides are new type of medicine that work rapidly to help the pancreas make more insulin just after meals. These are usually given in combination with other drugs and are taken 15-30 minutes before a meal. There are few side effects of these drugs such as weight gain or low blood sugar if you have not eaten adequately or skipped a meal.
Thiazolidinediones: This drug was introduced in the 1990s to improve insulin resistance in type 2 diabetes diabetes patients. With it, the cells of your body become more sensitive to insulin so that the blood can transport insulin to the blood cells for energy. Side effects with the drug may be:
Most doctors prescribe a combination of two or more drugs for the best diabetes care.