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INSULIN

2 min read

Introduction:

  • Insulin is a peptide hormone produced by beta cells in the pancreas.

  • It regulates blood glucose levels by facilitating glucose uptake into cells (liver, fat, and muscle tissues) and aids in the metabolism of carbohydrates, fats, and proteins.

  • In diabetes, impaired insulin production or function necessitates external administration.

Types of Insulin

Types of Insulin

  1. Rapid-Acting (Onset: ~15 min, Peak: 1-2 hrs, Duration: 3-5 hrs)

    • Examples: Lispro, Aspart, Glulisine

    • Uses: Mealtime glucose control.

  2. Short-Acting (Onset: ~30 min, Peak: 2-3 hrs, Duration: 5-8 hrs)

    • Examples: Regular Insulin (Humulin R, Novolin R)

    • Uses: Pre-meal and basal needs.

  3. Intermediate-Acting (Onset: ~2-4 hrs, Peak: 4-12 hrs, Duration: 12-18 hrs)

    • Examples: NPH Insulin (Humulin N, Novolin N)

    • Uses: Basal coverage.

  4. Long-Acting (Onset: ~1-2 hrs, Peak: Minimal, Duration: ~24 hrs)

    • Examples: Glargine, Detemir, Degludec

    • Uses: Basal insulin, once/twice daily.

  5. Ultra-Long-Acting (Onset: ~30-90 min, Peak: None, Duration: >24 hrs)

    • Examples: Degludec

    • Uses: Extended basal needs.

Mechanism of Action

Insulin lowers blood glucose by:

  • Facilitating Glucose Uptake: Promotes entry of glucose into muscle and fat cells.

  • Inhibiting Gluconeogenesis: Reduces glucose production in the liver.

  • Promoting Glycogen Synthesis: Enhances storage of glucose as glycogen in the liver and muscles.

  • Stimulating Lipogenesis: Encourages fat storage and inhibits lipolysis.

Uses

  • Type I Diabetes Mellitus: Essential for survival due to absolute insulin deficiency.

  • Type II Diabetes Mellitus: Used when oral antidiabetics are insufficient to control blood glucose levels.

  • Gestational Diabetes: Manages elevated blood sugar levels during pregnancy.

  • Hyperkalemia: Insulin shifts potassium into cells, lowering blood potassium levels.

Side Effects

  • Hypoglycemia: Low blood sugar levels, presenting as dizziness, sweating, confusion, and in severe cases, loss of consciousness.

  • Weight Gain: Increased fat storage due to insulin’s anabolic effects.

  • Injection Site Reactions: Redness, swelling, or itching at the injection site.

  • Allergic Reactions: Rare but may include rash or anaphylaxis.

  • Lipodystrophy: Changes in fat tissue at injection sites from repeated use.


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