What Is Insulin

Insulin is a peptide hormone produced by beta cells of the pancreatic islets; it is considered to be the main anabolic hormone of the body. It regulates the metabolism of carbohydrates, fats and protein by promoting the absorption of glucose from the blood into liver, fat and skeletal muscle cells.

Local Endocrinologists

Dr. Dina Prus

Dr. Dina Prus

Endocrinologist
Belleville, NJ
Dr. Roshney Jacob-Issac

Dr. Roshney Jacob-Issac

Endocrinologist
Belleville, NJ
Dr. Swaminathan Giridharan

Dr. Swaminathan Giridharan

Endocrinologist
Brooklyn, NY

Quiz: Do You Understand Insulin?

Test your knowledge by answering the following questions:

Questions
True
False
1

There are two ways to take insulin: by a syringe or injection pen.

Explanation:
People with diabetes take insulin by a syringe, injection pen or insulin pump.
2

There is a type of insulin called intermediate-acting insulin.

Explanation:
Types of insulin to treat diabetes include rapid-acting insulin, short-acting insulin, intermediate-acting insulin and long-acting insulin.
3

Blood glucose monitoring is an important part of any diabetes management plan.

Explanation:
Blood glucose monitoring is an important part of any diabetes management plan. If you have diabetes, it’s important to check your blood sugar levels as prescribed by your doctor. This will determine if you have low or high blood sugar.
4

All people with type 1 diabetes and type 2 diabetes require insulin.

Explanation:
All people with type 1 diabetes and some with type 2 diabetes require insulin to regulate blood glucose (sugar) levels.
5

A flash glucose meter (FGM) requires you to prick your finger.

Explanation:
You’ll need to get a blood glucose meter from your pharmacist or diabetes educator and learn how to use it. A traditional blood glucose meter uses lancets to puncture your skin. A flash glucose meter (FGM) is a newer device that doesn’t require you to prick your finger. Some people use a sensor inserted under the skin, called a continuous glucose monitor (CGM).
(Answer all questions to activate)

Diabetes and Insulin Treatment

So insulin is one of the options to treat diabetes, and there are many different types of insulin in order to be able to mix and match so that we can best suit the patient’s needs.

There are three broad categories of insulin, and the categories are divided based on the time/action profile, so when the insulins work. So, one category is the bolus insulin. The bolus insulin’s also known as the mealtime insulin. And as the name would suggest, it is designed as a fast insulin, so that it works at the same time as the food will. So it starts quickly, it peaks fairly quickly, and it runs away quickly, so that it matches a meal.

Another type of insulin, or the second type of insulin is a basal insulin, also known as a background insulin, meant for background. So it is a flatter, longer-acting type of insulin, so that it can serve the needs of the body all day long.

Remember that even if one has not been eating, we still need insulin, because insulin is a necessary hormone to move sugar from the blood into the cells, so that the cells can use it as energy. So therefore we also need that type of insulin.

And then the final type of insulin is called premixed. So premixed is premixed, so therefore it’s a mixture of bolus, and a basal insulin together, and it gives the advantage of convenience, because it’s one type on insulin, one injection, giving two types of insulin within it. However, you lose flexibility when one uses a premixed insulin.

So insulin is administered as an injection, and it’s administered through a very small needle, and that needle just goes just under the skin, or what we call subcutaneous. Now often when insulin is mentioned to someone they immediately picture a vial, and a syringe, and it’s often a needle that looks like the flu shot needle for example, which is the one that people are very familiar with. But it is nowhere close to that. The needle that is used is much, much smaller, much, much thinner, and shorter, and actually just goes under the skin.

The insulin itself also is not coming out of a vial, again what people tend to picture. But actually nowadays insulin looks nothing like that. Insulin is actually available as a pen device, and the insulin itself is in cartridges that could be installed into the pens, or the pens may already be prefilled, so it’s really easy to carry around.

And then the only part that needs to be added is the needle tip. Now the needle itself is actually much, much smaller than what most people imagine, and they’re also much more narrow. And then people often ask “well, does it hurt?” to actually do an insulin injection. Well if somebody is able to poke their finger to get blood to test their sugar, then they are more than able to do an insulin injection, because the insulin injection is actually less painful than poking the finger to test the blood.

So I think nowadays the administration of insulin is far simpler, people can carry it around very easily and the needle itself is much, much shorter and less painful than they ever were before.

If you’re a patient living with diabetes and interested in learning more about insulin, the best thing to do is to contact your local health care team, starting obviously with your family doctor, or a local endocrinologist, or the diabetes education team, or any other health care provider that may be available to you. Insulin Diabetes Now Patient Communication System

 

Local Practitioners: Endocrinologist

Richard Bebb, MD, ABIM, FRCPC, Endocrinologist: discusses insulin as a lifelong solution.

Are there Multiple Ways to Take Insulin?

There are generally three main ways to take insulin.

The first would be premixed insulin, where the product has already been mixed, perhaps short- and intermediate-acting insulins in the same vial; inject twice a day, usually breakfast and supper.

Another common way of doing it is to take a long-acting insulin once a day, often at bedtime, and still take your diabetes pills at mealtimes. And the third way, and perhaps the best for most people but the most work, is what’s called multiple daily injections, which would generally be one shot of long-acting insulin and then a short-acting shot at each meal.

It’s more work, but has a lot of benefit in terms of good control and flexibility of lifestyle. It’s important to discuss your particular situation with your pharmacist or health care provider in terms of how it impacts your health and may have an impact on other medications that you’re taking. Insulin Diabetes Now Patient Communication System

Presenter: Dr. Richard Bebb, Endocrinologist, Victoria, BC

Local Practitioners: Endocrinologist

Richard Bebb, MD, ABIM, FRCPC, Endocrinologist: discusses the ways you can take insulin.

Richard Bebb, MD, ABIM, FRCPC, Endocrinologist: discusses diabetes in men vs. women.

Diabetes - Insulin Management and Potential Side Effects

In terms of side effects from insulin, insulin allergies do occur – very, very exquisitely rare.

Mainly as a hormone, the side effects occur through overdose: too much, or too little. If you’re not getting enough insulin, your blood sugars are high. In the short term that may make you feel tired, fatigued, cause you to pee a lot, disturb your pee because you’re up peeing at night, and you’ll feel very lethargic and your muscles will cramp.

Too much insulin causes a low blood sugar – hypoglycemia. And the symptoms of that depend on how severe it is. In a mild form, it may make you shake, you’ll feel your heart pounding, you’ll sweat, you’ll get a headache, you’ll feel hungry, when you eat food it will go away.

More severe low sugars can cause seizures or patients to go into a coma. So clinically, we like to prevent that as much as possible, and again it’s a coordination with how much you’re eating, when you’re exercising and the dose of insulin.

So in terms of trying to prevent low blood sugars or hypoglycemia as a side effect of insulin, the key fact is education. This is a disease that patients live with, day in and day out. And we as healthcare providers have hopefully provided you the knowledge – either by interacting with us, your pharmacist or a diabetes centre – that you have the knowledge how to balance food, exercise and insulin, and minimize the chance of having a low blood sugar.

And key in this is the ability to measure your own blood sugar with a blood glucose monitor by fingertip testing. The knowledge of how insulin works – in general and also in your personal situation – along with your knowledge and the ability to test your blood sugar, will allow patients with diabetes to get the very best result for themselves. Insulin Diabetes Now Patient Communication System

Presenter: Dr. Richard Bebb, Endocrinologist, Victoria, BC

Local Practitioners: Endocrinologist

Is Insulin a Life Long Solution If You Are Diabetic?

In terms of trying to get off insulin, if you have type 1 diabetes, unfortunately the damage has already been done to your pancreas.

In short of having an islet cell transplantation, the insulin is a lifelong requirement. For patients with type 2 diabetes, if the patient is markedly overweight, we do have patients successfully lose large amounts of weight who will then be able to transition back from insulin onto pills, or even onto nothing other than diet and therapy.

Generally that’s going to take something quite marked, like 40 or 50 pounds of weight loss to get there but it does happen.

In terms of pharmaceutical product that’s otherwise an alternative to insulin there is a newer class of agents called incretin analogs, and these compounds work through a different hormone system than insulin and have two unique features compared to insulin.

The first is insulin makes you gain weight, these compounds help you lose weight. And the second issue is on their own by themselves the incretin don’t cause low blood sugars, insulin does.

It’s important to discuss your particular situation with your pharmacist or healthcare provider in terms of how it impacts your health, and may have an impact on other medications that you’re taking. Insulin Diabetes Now Patient Communication System

Presenter: Dr. Richard Bebb, Endocrinologist, Victoria, BC

Local Practitioners: Endocrinologist

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