Diabetes is a
disorder where there is an
insulin deficiency. What this means is that your
pancreas is unable to deliver enough
insulin to control the rising blood glucose levels after eating. The main source of fuel or energy comes from the
glucose in your diet. When you have
diabetes this mismatch of insulin supply results in
high blood glucose and well recognized symptoms.
Type 1 diabetes is a
disorder where the
insulin producing cells of the
pancreas are destroyed resulting in very little
insulin secretion.
In
Type 2 diabetes the
pancreas is still able to make
insulin but needs a top up.
The manufacture of
insulin is primarily designed to be either absorbed into the body
slowly over many hours or
rapidly.
Long acting insulin is prescribed to give you a constant
background of insulin.
Rapid acting insulin is prescribed to control the blood glucose peak which occurs immediately after eating. Your doctor may prescribe a combination of
both types of insulin.
Something to consider before deciding on an actual
insulin regime is the type of
insulin to be used. In this respect there are
insulin preparations obtained from
cows and
pigs known as
bovine and
porcine insulin respectively.
There is
human insulin, which is produced by a technique of genetic engineering using the
human insulin gene sequence inserted into yeast cells in culture.
Finally
insulin can also be designed in the laboratory to be absorbed either rapidly or very slowly. These are known as
insulin analogues.
The main principle concerning the choice of any
insulin regime is whether you decide to use a
rapid acting insulin,
a slowly absorbed background insulin or
mixtures of both. The least intensive is once daily
background insulin and the most intensive could be considered a
background insulin plus rapid insulin before each meal. The
insulin mixtures are intermediate and usually given twice daily before breakfast and before dinner although they are sometimes given at lunchtime as well.
Ways to administer Insulin There are several ways that insulin can be administered.
The standard method for many decades has been
via subcutaneous injection. This is where the
insulin is injected just under the skin and then from there absorbed into the bloodstream.
Whether the insulin is delivered by
syringe, pen injectors or
insulin pumps the principle is the same. There are, however, small variations in the
insulin molecule produced by different manufacturers and the speed of absorption into the body depends on this and on the solution in which it is dissolved for injection. This produces a wide variation of
insulin preparations available for clinical use.
An alternative method of
insulin delivery includes
inhaled insulin, which was available for a short time but has now been taken off the market. Researchers are still exploring this avenue. Currently in
development are
oral insulin tablets and
insulin contained in
buccal sprays.