Insulin therapy – insulin for type 1 and 2 diabetes mellitus: indications, types, how to use

Insulin is a peptide hormone that is produced by the pancreas and regulates the metabolism of carbohydrates within the body. This hormone is prescribed to patients with diabetes mellitus because the body itself is not able to produce enough insulin. This maintains the balance of blood sugar. Over time, the pancreas is depleted under the influence of the disease, there is a violation of the functions of the organ, including the production of insulin. Therefore, injectable hormone solutions help maintain the necessary balance. The reasons for the development of a condition in which insulin is required are the following factors:

  • non-standard (complicated) development of diabetes mellitus;
  • very high sugar content – more than 9 mol / l;
  • excessive use of products with a high content of sulfonylurea .

The use of the hormone allows you to achieve the following effects:

  • the process of glucose absorption improves;
  • the production of glucose in the liver decreases;
  • the work of enzymes that are responsible for the breakdown and absorption of sugar in the blood is normalized;
  • the hormone helps convert glucose to glycogen.

Due to these processes, carbohydrate metabolism is being established, which has a positive effect on the whole body and prevents the development of complications in diabetes mellitus. Improper production of the substance can lead to negative consequences in the form of trophic ulcers, diabetic coma or death.

Indications for insulin treatment

Uncontrolled use of the drug can lead to the development of complications. Therefore, the attending physician is exclusively responsible for prescribing the hormone. Basically, the drug is prescribed when the diagnosis of diabetes mellitus is made. However, the hormone can be used for other pathologies as well. Indications for use:

  • lowering sugar levels;
  • ketoacidosis ;
  • glucosuria;
  • hyperglycemia;
  • hypoglycemia;
  • lack of a compensatory effect;
  • diabetic coma;
  • infectious and inflammatory diseases;
  • heart attack;
  • circulatory disorders;
  • during the period of surgical intervention;
  • underweight.

Insulin is not used when blood sugar levels are low. The hormone is used in both type 1 and type 2 diabetes mellitus.

Insulin treatment for type 1 diabetes

Type 1 diabetes mellitus is an endocrine chronic disease, expressed by an increased blood sugar level. It belongs to the insulin-dependent type. Diabetes is treated with insulin because the pancreas stops making the hormone. Often, the disease develops in childhood or adolescence. In adulthood, the disease develops gradually and may be asymptomatic. During the recovery period or at normal sugar levels, the use of insulin is not recommended, since otherwise such treatment can provoke the development of hypoglycemia. The dosage of the hormone is selected in each case separately and monitored by the attending physician. Any deviation from the norm can cause drops in sugar, which is dangerous for the development of complications. Insulin is given by injection (injections) to compensate for the hormone inside the body. Therapy will be more effective when it is accompanied by adherence to a specific (low-carbohydrate) diet, since very often type 1 diabetes is complicated by being overweight.

Insulin treatment for type 2 diabetes

Type 2 diabetes mellitus develops against the background of excess weight (obesity) or a sedentary lifestyle. With an illness, the sugar level may be normal or slightly higher. However, due to the excessive attacks of the immune system on the beta proteins, they are partially killed. Therefore, the use of the hormone for type 2 is justified. Since type 2 diabetes mellitus is accompanied by overweight, it is required, as in type 1, to follow a diet low in carbohydrates. The use of insulin injections gives the maximum effect, in contrast to tablets, which are destroyed by the action of digestive enzymes, getting into the gastrointestinal tract. The scheme of administration of the hormone in diabetes is compiled by the doctor according to the severity and associated complications. To control the sugar level before using the drug, it is required to take measurements with a glucometer at least 5 times a day.

Hormone shots are given based on blood sugar measurements. Patients are advised to independently study the techniques of such injections.

Insulin types

Before using the drug, it is required to study the available types and read the instructions. Each of them has indications, its own speed of action and the duration of the therapeutic effect. Based on this, the hormone is usually subdivided into the following classifications:

  • the rate of action of the drug after administration;
  • time of action;
  • composition of the medicinal product;
  • release form.

Insulin by speed and time of action

Depending on the speed of action and the duration of the effect of the drug after its administration, insulin is divided into the following types:

  • Ultra-short (fast-acting). This type of agent acts almost instantly after entering the bloodstream. The effect of the drug ends 4 hours after administration. Apply before or after meals. Popular and widespread drugs in this group are: NovoRapid , Humalog , Apidra . 
  • Short. The action of this type of funds begins 20-30 minutes after administration. The duration of the effect is about 6 hours. It is introduced strictly before meals. Known drugs: Actrapid NM, Humulin Regular , Monodar , Humodar R, Biosulin R. 
  • Average action time. The validity period is from 12 to 16 hours. The effect occurs in 2-3 hours. Enter regardless of food intake from 2 to 3 times a day. List of products: Biogulin N, Biosulin N, Monodar B, Monotard MS. 
  • Long lasting. The effect of the introduction is observed after 4-8 hours, the duration of action is from 36 hours to 2 days. Preparations: Lantus , Levemir Penfill . 

There are a huge number of insulin – containing preparations on the market , however, the selection and appointment is carried out exclusively by the attending physician.

Insulin composition

Insulin preparations are natural and synthesized . Also, drugs are divided into one-part and two-part (two-phase). The biphasic formulations include short and medium term agents. Synthetic insulin is produced through genetic engineering. In terms of parameters, it is very similar to insulin, which is produced by the human pancreas. But unlike human, it is assimilated by patients much better and is not rejected as something alien. Semisynthetic insulin (animal, human) can cause hypoglycemia if used incorrectly. It is absorbed longer, but softer, in contrast to the synthetic derivative of the hormone.       

Release forms

For the treatment of diabetes mellitus, the agent is produced in various forms and packages. This allows the necessary injection to be made without difficulty. Forms of medication:

  • vials – a set of funds occurs with a syringe; 
  • cartridges – injections are carried out using a special syringe pen. 

Other forms of the hormone are not produced due to their complexity and low effectiveness.

Drawing up an insulin therapy regimen

Insulin therapy schemes are developed by the attending physician for each patient individually, based on the severity and type of the disease, as well as existing complications. In addition, indicators of sugar level and other signs that contribute to the development and course of the disease are taken into account. Additional factors influencing the development of insulin therapy regimens are:

  • the presence of other diseases;
  • taking pills for diabetes (dosage, time);
  • eating food (diet);
  • physical exercise.

Insulin therapy is traditional and basic-bolus (intensified). In the absence of a disease, after a meal, a stable and definite amount of the hormone is produced. This phenomenon is called basic. A food bolus is the storage of a certain level of insulin in reserve.  

Traditional insulin treatment is the constant administration of the hormone with a reference to the time and the required dosage. Therefore, it is customary to do 2 injections of short and medium long-acting at once twice a day.

Calculation of insulin in diabetes mellitus

To calculate the scheme, you must have a notebook with the indicated sugar indicators at different times of the day throughout the week. Measurements are made using a special apparatus that monitors the sugar level – a glucometer . With diabetes mellitus, the required dose of insulin is 40 units on average. A patient with type 2 disease and low physical activity can be prescribed a single injection of the hormone in the morning before eating. Treatment is considered mixed, taking into account the fact that in the evening the patient takes sugar – reducing drugs before dinner . With type 1 disease, such therapy is not prescribed. The scheme is considered inadequate due to the fact that it has risks of developing complications such as hypoglycemia or metabolic disorders. Double use of the hormone is prescribed for both type 1 and type 2 pathology. The dosage of the agent is divided into two parts, for example, 30 IU and 10 IU or 27 IU and 13 IU. The hormone is injected twice a day – in the morning and in the evening. With this scheme, medium-acting insulin is used. Often, 1 injection of a short one (in the morning) and 1 – medium (in the evening) are used. If the patient has an increased load, then the morning dose of short-acting is increased by 2 units, and the evening dose of medium action is reduced by 5-6 units. During the feast, the morning injection is increased by 4 units, and the evening one remains the same. This method implies strict adherence to the diet. Three times administration of the hormone is the most common treatment regimen for diabetes mellitus. In the morning before breakfast, a mixture of short-acting and long-acting insulin is administered. In the evening, before dinner, “short” insulin is used, and a long-acting insulin is administered at night. The patient can change the dinner time, then a reduced amount of the drug is administered at night.

The treatment regimen for gestational diabetes is not only based on sugar indicators, but also according to the gestational age.

How to inject insulin for diabetes?

The introduction of the substance is not recommended for children under 12 years old, people with low vision, as well as those who have mental disorders. In this case, the injections are performed by a doctor or nurse. To carry out the injection, you must have the drug itself, a syringe with a needle, cotton wool, an alcohol solution for disinfection, as well as a container for storing the syringe. Injections are given according to the following scheme:

  1. Surface treatment.
  2. Gripping the required surface with 2 fingers.
  3. The introduction of the needle is made with a sharp, jerky motion.
  4. Using a piston, insulin is injected slowly and smoothly.
  5. After the end of the procedure, it is required to stand for 5-7 seconds, and then sharply pull out the needle.

The most suitable sites for injection are the buttocks, thighs, abdomen and shoulders. In the abdomen (2 cm from the navel), the absorption of the substance occurs fastest. It is necessary to avoid areas on the body where formations are located (moles, lipoma). Don’t squeeze the folds of the skin too tightly. If pain or discomfort occurs, it is recommended to push the needle a little deeper. The used syringe is stored in a special container, which, as it is filled, is handed over to the disposal organization.

Insulin storage rules

Insulin is a fragile substance that, if stored improperly, undergoes a loss of its qualities and properties. The medicine should be in a dark and protected place, out of direct sunlight. You should also avoid storing the drug in places with low temperatures, which can cause complete or partial freezing. The bottle with the product is stored under a tightly closed lid at a temperature not exceeding 25 degrees. In this condition, the medicine retains its properties for up to 4 weeks. Storage in the refrigerator at a temperature of 2 to 8 degrees can extend the shelf life of the drug to 6-8 weeks. This is especially true for bottles that are used to refill cartridges. When traveling or moving, the medicine is best kept in a container designed to store insulin. The medicine should not contain impurities or change color. Otherwise, such a tool is considered unsuitable, and its use is prohibited. Also, the drug should not be taken in cases where there is no effect after the injection. It is forbidden to use the product after the expiration date.

It is better to purchase medicine in specialized medical stores or pharmacies. It is forbidden to buy medicine from hands!

Before use, it is recommended to carefully study the instructions for the drug and read the rules of use.

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