Insulin Basics by Elizabeth "Bjay" Woolley (09-05-2001) Here is a very brief introduction to insulin

Insulin is the "key" that opens the doors in cells to let glucose (sugar) in. The body needs glucose for energy. In people with diabetes, either the pancreas no longer produces any/enough insulin or the insulin no longer fits into the "keyholes" to open the doors to the cells. If glucose cannot get into cells, it accumulates in the bloodstream.

Normally blood glucose is 90 mg/dl fasting and before meals. It should be below 120 mg/dl one hour after meals. It is especially important for pregnant diabetics to follow a special diet, exercise, and/or inject insulin to keep blood glucose within normal range.

Everyone is different and has a unique lifestyle. Health care providers will work with diabetics to tailor regimens (diet, exercise, medication) to fit their needs. Once a plan is made, it needs to be religiously followed. Everything works together. Once injected, insulin starts to lower glucose levels. Meals and snacks must be eaten to keep glucose levels from plunging too low. Regular meals and snacks eaten throughout the day help keep glucose levels as stable as possible. Exercise fits into the overall picture by lowering glucose levels and, in turn, lowering insulin needs.

There are many types of insulin. It can be confusing to try to understand them all. What follows is a general overview:

There are three forms of insulin: pork, beef, and human (made in a lab through genetic engineering). Insulin varies in the timing of the action. Please note that each individual insulin product performs differently. In addition, insulin performs differently for every individual and at various times of the day. The insulin package insert must be read for more accurate information. In general, these are the three main types of insulin:

• Regular (rapid or short-acting) - Reaches bloodstream within 30 minutes, peaks about two to three hours after injection, and remains in blood for about six hours.

• NPH and lente (intermediate-acting) - Reaches bloodstream in about four hours, peaks seven to eight hours after injection, and remains in blood for up to 18 hours.

• Ultralente (long-acting) - Reaches bloodstream in about four to six hours, peaks about 14 to 18 hours after injection, and remains in blood for up to 24 hours.

There are also premixed mixtures such as Humulin 50/50 or Humulin 70/30 which have various action times.

Diabetics may be prescribed more than one insulin type. Doctors, nurses, and diabetes educators teach diabetics how to draw, mix, and administer their own injections. Insulin can be administered via syringe, jet injectors, or pumps. Syringes today have short micro-fine needles that are almost painless. Jet injectors are devices that shoot the insulin through the skin in a jet stream. Insulin pumps are small computerized devices that deliver insulin throughout the day via a tube connected to a needle inserted into your skin.

In pregnant diabetics, the placenta produces hormones that make insulin less effective. Insulin needs might double or even triple during the course of pregnancy. The insulin regimen may change every 5 to 10 days as insulin needs increase with a corresponding increase in injections. Because of this, regular and frequent blood glucose monitoring is vital.

As a diabetic, your physician may instruct you on how to make the necessary adjustments in your insulin dose yourself. If it is too confusing for you, don't be afraid to let your physician know and have a member of your health care team follow up with you weekly and inform you of the adjustments to make. This is a team effort, and your health care team is there to help you.

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This is not a health care site. The editor is not a health care professional, is not qualified, and does not give medical or mental health advice.

Please consult with qualified professionals in order to find the right regimen and treatment for you. Do not make changes without consulting your health care team. .

Because this site is for all diabetics at all stages of life, some information may not be appropriate for you - remember information may be different for type 1, type 2, type 1.5, and gestational diabetics.

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