Diabetes And Insulin

As you are aware if insulin is not produced in sufficient proportion in the body or if it is not effective despite its presence, diabetes is caused. As insufficiency of insulin is the cause of diabetes; insulin is the supplementary substance and the key drug for this disease.

In 1921, insulin was invented by two doctors — Frederick Banting and Charles Best. Before that, patients with type 1 diabetes would die within 6 months of diagnosis. After the invention of Insulin, it became a “sure-shot medicine” for such patients.

The characteristic of insulin is such that if it is taken orally, it gets destroyed in the stomach and intestines (due to digestive system). Therefore, until a new invention comes along, insulin can only be administered intravenously. If insulin can be taken orally, there would be no need for scientists to search for any other medicines.

Who needs insulin?

• Type 1 diabetes patients
• Type 2 diabetes patients when the disease is not controlled by medication

Besides, type-2 diabetes patients may be required to take insulin in the following circumstances.

• Loss of weight inspite of taking medicines
• in case of heart disease or paralysis
• in case of disease related to liver or kidney
• in case of infection, fever or TB
• when toxic substance like Acetone circulates in blood
• during operation
• during pregnancy

After the illness is cured, insulin can be stopped in such patients. Insulin is administered in the dosage of a unit. One unit of insulin reduces sugar in blood to some extent. Reduction of sugar from blood varies from a person to person.

Is it necessary to take insulin, once it is taken?

As we discussed, insulin is the necessity of the body. It is not an intoxicating substance that, one gets addicted to it. The circumstance under which insulin was prescribed, when such a situation is resolved, insulin could be stopped in accordance with the doctor.

How is insulin sourced?

Bovine

For several years now insulin has been obtained from cows. There is a difference of three amino acids between human insulin and bovine insulin. Since this is cheaper, many patients use this insulin.

Porcine

This insulin is a newer one. It is made from swine. There is a difference of one amino acid between human insulin and this insulin.

Human

This insulin is not made in a human source but from yeast and e-coli bacteria, using the latest technology. This is similar to human insulin.

Analogue

This type of insulin has been available for some years now. The advantage with this insulin is that it can be taken immediately before meals, and not before 15-30 minutes before meals as is the case with other kinds of insulin.

Only your doctor can determine which insulin should be taken, when and in what dose. Therefore, follow the doctor’s advice. Don’t change the dosage of insulin even if you feel better.

Method of administering insulin by injection

For this purpose you will need an insulin bulb, syringe cotton and spirit. Before administering injection, do not forget to wash your hands.

1. If you are using turbid or milk-white injection, shake the bulb up and down two to three times, or roll between your two palms, so that the solution gets properly mixed.
2. If you are using a new bulb of insulin, remove the coloured plastic cap from the top. Do remember that the rubber or plastic part is not to be removed. After this, clean the rubber part with spirit-dipped cotton swab.
3. Now, pull the plunger of injection to let the air enter the cylinder equal to the dosage to be administered.
4. Insert the needle of the syringe in the bulb through the rubber. Slowly push the air trapped in the syringe into the bulb.
5. Keeping the needle below insulin level, fill up the syringe properly with insulin. Tap the syringe to let the air bubbles escape.
6. Ensure that the syringe contains the exact quantity of insulin. If you have taken more insulin than prescribed, return some of it into the bulb, and pull out the needle. Now the syringe is ready for administering insulin injection.
7. Clean the surface where insulin injection is to be administered. Pinch the skin and lift up the fold, and insert entire needle down at 45⁰ to 90⁰ angle.
8. Insert insulin very slowly into the body. When you pull the needle out, mildly press the place of injection for some time. (Do not rub the place.) Ensure that insulin is not oozing out of the skin.

If spirit is not available, after shave lotion, Dettol or Savlon could be used instead.

Can you administer injection yourself?

The method of administration of insulin is simple. Even small children and illiterate individuals can easily do it themselves. Therefore, as far as it is possible, the injection should be administered by the patients themselves. If it is not possible, other family members should learn to administer the injection. Visiting a doctor for taking an injection is expensive, uncomfortable and impractical.

Where to inject?

Injection can be administered on the arm, leg or abdomen. Keep changing the site of the injection, so as not to damage the tissues below the skin.

Which is the best site for injection?

It is better to administer the insulin injection on abdomen. After administrating the injection in hands or legs, due to the movement of limbs insulin absorption fluctuates. This causes a fluctuation of sugar in blood. Usually, abdomen does not move despite the movement of the body, hence blood sugar level does not fluctuate.

Absorption speed of insulin

Spot of injection Speed

Leg Slow

Hand Moderate

Abdomen Fast

How should injection be taken?

The insulin injection should be taken in the fatty layer below the skin. If you take it in the skin, it will cause pain. If you take it in the tissues located below the fatty layer, insulin will be absorbed rapidly, as a result, the possibility of a reduction of sugar in blood may increase.

What if injection is missed?

The timing of insulin injection is set in such a manner that it can tackle the foods being consumed at the time of breakfast, lunch, dinner etc. If the injection is taken a bit late, it is possible that sugar in blood decreases. Therefore, if insulin is not taken on time, it is better to avoid taking injection or follow the advice of the doctor.

Can disposable syringe be re-used?

A disposable syringe is meant for one-time usage. However, you can use it (one syringe for one person), if you do not apply spirit on the needle, keep the syringe properly back in a clean box after using it, do not wash the syringe with water or boil it, until needle become blunt or injection causes pain. In normal circumstances, a syringe can be used 5-10 times.

What is Insulin Pen?

Insulin pen (NOVOPEN, NOVOLET, HUMAPEN) is the accurate and easier means of taking the insulin injection. Insulin is not wasted. Since the cartridge of insulin is within the pen, filling up insulin is not required. The pen can be carried in a pocket so it becomes easier to take insulin for busy individuals. Since figures need to be moved in accordance with the dose of insulin to be taken, it is beneficial for the children, aged persons and those with poor eyesight.

Does insulin cause unconsciousness?

After taking insulin if the patient eats belatedly, inadequately or does not eat at all, or engages in excessive physical exercise, the possibility of unconsciousness rises due to the depletion of sugar level in blood.

Method of prevention: Timely insulin, timely meals, proportionate exercise and avoidance of fasting.

What should be the time gap between meal and insulin?

Timing of the injection depends on the type of insulin.

Type of insulin Timing

Short-term effect 15 minutes before meals

Long-term effect 30 minutes before meals

Analog Immediately before meals

Does the injection cause pain?

As a result of inventions done over the years, the gauge (31-32) of the needle of injection has become much thinner. As a result the injection is absolutely painless.

Is insulin very costly?

The price of insulin depends on its type. If inexpensive insulin is effective, there is no need to take expensive insulin. Not taking insulin, however, can cause short-term and long-term harm, and its treatment is more expensive.

FALSE BELIEF –

One doctor prescribes insulin and the other doctor prescribes tablets; hence, the doctor prescribing tablets is better doctor.

All other diabetic patients are taking tablets, so why Insulin is given to me?

I will not take Insulin injection, I will do anything else you tell.

Important for patients taking insulin:

• As far as possible, store insulin in a refrigerator.
• Do not store insulin in the freezer compartment, but store it in a rack on the door.
• If you cannot store insulin in a refrigerator, store it at a place which is cool, and away from direct sunlight, e.g. a place to store potable water, or a closed cupboard.
• Ensure that your syringe volume matches the dosage on the insulin bulb; e.g. for a 40 I.U. units insulin, you will need a syringe of 40 I.U.
• While you travel, always carry insulin in a small bag with you.

What is insulin pump?

For the first time ever in Asia, this facility has been made available by “Swasthya Diabetes Centre” to thousands of children suffering from diabetes. With the help of this pump, insulin is administered in the same way as insulin exudes in the body of a healthy person. As a result one can live life like a healthy individual.

Management can be done to maintained glucose level in blood, even if the young friends eat less, eat late or do not eat. Moreover, care can be taken to ensure that glucose does not increase in blood, even if the children consume foodstuffs of their choice. In comparison with other diabetes patients, lifespan of patients can be increased to over five years and the adverse effects of the disease can be evaded for over fifteen years with the help of the pump.