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• Understanding Insulin
Insulin
prevents or controls many symptoms of diabetes and contributes to your
overall strength and weight control. Insulin has become easier and safer to
use since 1921 when it was developed. Present day insulin preparations are
purer and more concentrated than those of some years ago,. and less fluid is
required to obtain the necessary dose. Consequently, diabetics now can have
fairly good control over their disease more readily. Also, needles for
insulin injections, particularly the disposable type, have been improved and
are now small and nearly painless. Overall, insulin therapy has become more
convenient and easier than it used to be.
Your doctor will review with you the various types of insulin available, the
type and dose that best meets your individual needs, and how and when
to take your injection. For example, you may be advised to take the insulin
about one-half hour before breakfast or before the evening meal or
occasionally before other meals or bedtime.
Where does
insulin come from? Most insulin now being used to treat diabetes comes from
the pancreases of hogs and cattle. It is manufactured as pure pork insulin
or pure beef insulin, though the most widely used insulin is a mixture of
both kinds. Your physician will determine which is best for you. Beef and
pork insulin's are not chemically the same, and they are not chemically the
same as insulin made by the human pancreas. All types of insulin are
proteins and are made from the body's building blocks called amino acids.
Human, beef, and pork insulins all have 51 amino acids. Pork insulin has one
amino acid different from human insulin, while beef insulin and human
insulin differ in three amino acids. Pork insulin, is more like human
insulin.
Recently, human insulin has been produced by bioengineering techniques. It
has been cleared by the U. S. Food and Drug Administration and will soon be
available for use.
Some people react differently to beef insulin and pork insulin. One person
may have an allergic reaction whenever beef insulin is injected while
another may not. The same is true of pork insulin.
For individuals who have certain types of adverse reactions to mixed
insulin, the more highly purified pork insulin may be the best choice.
If you are not allergic or resistant to any type of insulin, it may not
matter which type you use. However, you may have a minor amount of
resistance to either type of insulin, which does not become apparent until
the type of insulin is changed. For example, if you change from one type to
another, you may find that you need more or less of the new type to bring
your glucose level under control.
Your medical team, consisting of your physician, a nurse, and usually a
nutritionist, will assist you in understanding how to inject insulin, what
to expect in the way of reactions, and how to avoid them. They will discuss
with you the importance of rotating the site of injection. For example, you
should not use any site of injection more than once every 15 days because
doing so may cause the absorption of insulin to vary and fluctuations in
blood sugar may occur. Also, rotation of sites helps avoids bumps and
indentations in your skin. Insulin is absorbed more slowly in your legs than
your abdomen and more slowly in the arms than in your abdomen. Commonly
recommended sites are the outer area of the upper arm, the abdominal area
below the waist, the upper area of the buttock just behind the hipbone, and
the front of the thigh above the knee, as shown below.
If Your Doctor
Has Prescribed Insulin Injections For Treatment
□ Don't
resent or try to escape from it, it is essential for your good health and
survivial.
□ Tablets
are no substitute for Insulin. Your diabetes has reached a stage when
tablets are not effective.
□ Insulin
is not habit forming. In some cases, once the emergency situation is over
you could go back to tablets or diet alone.
□ Insulin
injected works only for 6 to 24 hours. It has to be repeated every day.
There is no fixed duration of course of Insulin.
□ Insulin
cannot be given by mouth. You have to accept Insulin injections.
□ Learn
to take Insulin injections yourself.
□ Learn:
• How to use and sterilize syringes.
• How to fill the required dose in the syringe.
• How and where to take Insulin injections.
• To manage minor adjustment of dose of Insulin.
• To recognize hypoglycemic reactions and its remedy.
• TO check urine or blood sugar yourself.
□ Carry
identity card mentioning your name & address, dose of Insulin and address of
your family doctor.
Pharmaceutical
companies that produce insulin prepare instructional materials that explain
techniques for injecting insulin; because these materials are readily
available, details are not given here. Also, details on mixing insulin will
be given by your physician as well as the manufacturer of the product you
will use.
No two people are alike, and an identical dose of insulin in two people may
have vastly different effects. That is why your physician will explain the
importance of monitoring the effects of the insulin through urine or blood
sugar testing.
If your job or exercise routine calls for using certain parts of your body
more than others, your physician will give you special instructions
regarding injections. For example, if you are a jogger and must move your
arms and legs, you will probably be advised not to inject insulin into your
thighs and arms because exercise causes more rapid absorption can lead to
hypoglycemia.
Your medical team will tell you how to treat an insulin reaction by
yourself. Whil insulin reactions are not common, they can happen, and you
will need to know how to recognize these and take care of yourself. You will
probably be advised to carry carbohydrate and protein sources to eat before
you exercise or work strenuously and to keep quick sources of carbohydrates
handy, such as sugar-containing fruit drinks, honey, or orange juice. You
may want to ask your health care team about using glucagons therapy for
insulin shock. Glucagon is a substance produced by the alpha cells of the
pancreas which increases blood sugar and reverses an insulin shock reaction.
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